Abstract: 【Abstract】Objective To evaluate the risk factors of coronary artery calcification (CAC) in patients with chronic kidney disease (CKD) stage 3～5 and the relationship between iron metabolism indices and CAC. Methods One hundred and sixty-two patients with CKD stage 3～5 in the Department of Nephrology of the Second Hospital of Anhui Medical University were recruited. Clinical data and laboratory indices were collected. Serum iron, ferritin, transferrin and total iron binding capacity (TIBC) were examined, and transferrin saturation (TSAT) was calculated. Ferrin> 800 μg/L and/or TSAT> 50% were defined as iron overload. The coronary artery calcification score (CACs) was measured by multi-slice spiral computed tomography. According to CACs>10, patients were divided into calcification group and non-calcification group. To investigate the correlation between iron metabolism and CAC, and to explore the predictive value of risk factors on CAC. Result Ninety-two patients (56.8%) had CAC. Transferrin and TIBC were negatively correlated with CACs (r=-0.293, -0.253, P < 0.001, 0.001, respectively). Binary logistic regression analysis showed that old age(OR=1.050, 95% CI=1.013～1.088, P=0.007), diabetes (OR=4.712, 95% CI=1.445～15.371, P=0.010), higher neutrophil- lymphocyte (NLR) (OR=1.253, 95% CI=1.025～1.533, P=0.028), higher blood phosphorus (OR=3.981, 95% CI=1.791～8.849, P=0.001), and lower transferrin (OR=0.130, 95% CI=0.044～0.378, P< 0.001) were independent risk factors of CAC.ROC curve showed that the area under the curve of combined prediction of CAC by age, diabetes, NLR, blood phosphorus and transferrin was 0.828 (95% CI 0.766～0.891, P<0.001), the sensitivity was 79.3%, and the specificity was 75.7%. Conclusion The incidence of CAC was high in patients with CKD stage 3～5. Old age, diabetes, hyperphosphatemia, high NLR and decreased blood
transferrin level are independent risk factors of CAC. The combined indicator including the above risk factors has good predictive value for the occurrence of CAC.

Key words: coronary artery calcification, chronic kidney disease, iron, transferrin