Table 3.
Associations of 24-h urinary calcium with risk of end-stage kidney disease, chronic kidney disease progression, all-cause mortality, and atherosclerotic cardiovascular disease
| Outcomes | Continuous | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 |
|---|---|---|---|---|---|---|
| ESKD | ||||||
| Events, n | 1057 | 317 | 287 | 209 | 154 | 89 |
| Event rates (per 100 person-years) | 3.48 | 6.31 | 5.19 | 3.55 | 2.32 | 1.22 |
| Crude | 0.65 (0.62, 0.69) | 1 (Reference) | 0.80 (0.68, 0.95) | 0.56 (0.46, 0.67) | 0.38 (0.31, 0.46) | 0.20 (0.16, 0.26) |
| Multivariable Model 1a | 0.71 (0.67, 0.76) | 1 (Reference) | 0.79 (0.66, 0.95) | 0.63 (0.52, 0.76) | 0.45 (0.37, 0.56) | 0.29 (0.22, 0.37) |
| Multivariable Model 2b | 0.90 (0.84, 0.97) | 1 (Reference) | 0.90 (0.75, 1.08) | 0.82 (0.67, 1.00) | 0.80 (0.64, 1.00) | 0.70 (0.54, 0.92) |
| Multivariable Model 3c | 0.96 (0.89,1.04) | 1 (Reference) | 0.94 (0.78, 1.14) | 0.87 (0.70, 1.09) | 0.94 (0.74, 1.19) | 0.83 (0.62, 1.11) |
| CKD progression (ESRD or 50% eGFR decline) | ||||||
| Events, n | 1334 | 365 | 342 | 268 | 215 | 143 |
| Event rates (per 100 person-years) | 5.73 | 9.55 | 8.34 | 6.02 | 4.15 | 2.49 |
| Crude | 0.69 (0.66, 0.73) | 1 (Reference) | 0.87 (0.74, 1.01) | 0.62 (0.52, 0.73) | 0.44 (0.37, 0.53) | 0.27 (0.22, 0.33) |
| Multivariable Model 1a | 0.76 (0.72, 0.80) | 1 (Reference) | 0.89 (0.75, 1.06) | 0.70 (0.58, 0.84) | 0.52 (0.43, 0.64) | 0.40 (0.32, 0.49) |
| Multivariable Model 2b | 0.94 (0.88, 1.00) | 1 (Reference) | 0.96 (0.81, 1.14) | 0.87 (0.72, 1.05) | 0.84 (0.69, 1.02) | 0.83 (0.66, 1.04) |
| Multivariable Model 3c | 0.99 (0.93, 1.06) | 1 (Reference) | 1.02 (0.85, 1.21) | 0.96 (0.80, 1.17) | 0.97 (0.79, 1.19) | 0.94 (0.73, 1.20) |
| All-cause mortality | ||||||
| Events, n | 1268 | 304 | 285 | 289 | 213 | 177 |
| Event rates (per 100 person-years) | 3.55 | 4.45 | 4.07 | 4.23 | 2.91 | 2.31 |
| Crude | 0.83 (0.79, 0.88) | 1 (Reference) | 0.94 (0.79, 1.12) | 0.95 (0.80, 1.12) | 0.64 (0.53, 0.76) | 0.57 (0.44, 0.73) |
| Multivariable Model 1a | 0.92 (0.86, 0.99) | 1 (Reference) | 0.88 (0.74, 1.06) | 0.95 (0.79, 1.13) | 0.69 (0.57, 0.85) | 0.80 (0.60, 1.07) |
| Multivariable Model 2b | 1.03 (0.96, 1.11) | 1 (Reference) | 0.91 (0.77, 1.08) | 1.08 (0.91, 1.27) | 0.88 (0.72, 1.06) | 1.19 (0.93, 1.54) |
| Multivariable Model 3c | 1.05 (0.98, 1.13) | 1 (Reference) | 0.94 (0.78, 1.12) | 1.11 (0.93, 1.32) | 0.92 (0.75, 1.13) | 1.27 (0.98, 1.66) |
| ASCVD (including MI, stroke, or PAD) | ||||||
| Events, n | 714 | 157 | 176 | 147 | 137 | 97 |
| Event rates (per 100 person-years) | 2.33 | 2.68 | 3.04 | 2.52 | 2.19 | 1.42 |
| Crude | 0.83 (0.78, 0.89) | 1 (Reference) | 1.14 (0.91, 1.44) | 0.99 (0.78, 1.26) | 0.83 (0.65, 1.06) | 0.49 (0.38, 0.65) |
| Multivariable Model 1a | 0.93 (0.86, 1.00) | 1 (Reference) | 1.05 (0.83, 1.34) | 0.98 (0.77, 1.26) | 0.93 (0.72, 1.20) | 0.71 (0.53, 0.95) |
| Multivariable Model 2b | 1.01 (0.93, 1.09) | 1 (Reference) | 1.08 (0.85, 1.37) | 1.08 (0.84, 1.38) | 1.09 (0.84, 1.42) | 0.91 (0.67, 1.25) |
| Multivariable Model 3c | 1.03 (0.95, 1.13) | 1 (Reference) | 1.13 (0.89, 1.45) | 1.14 (0.88, 1.47) | 1.18 (0.89, 1.56) | 0.99 (0.71, 1.38) |
Abbreviations: ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; ASCVD, atherosclerotic cardiovascular disease; BMI, body mass index; BP, blood pressure; CCID, clinical center identification; CKD, chronic kidney disease; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; ESKD, end-stage kidney disease; MI, myocardial infarction; PAD, peripheral arterial disease; PTH, parathyroid hormone.
aModel 1 = stratified by CCID, adjusted for age, gender, race, CCID, BMI, diabetes, systolic BP, CVD, and 24-h urinary creatinine.
bModel 2 = Model 1 + adjusted for eGFR at baseline.
cModel 3 = Model 2 + adjusted for lab tests at baseline including hemoglobin, serum albumin, ln (PTH), and medication use at baseline including loop diuretics, thiazide diuretics, phosphate binder, active vitamin D, ACEi/ARB, beta blocker, statins, and antiplatelet.