Abstract: Objectives  To analyze the risk factors of coronary artery calcification (CAC) in chronic kidney disease (CKD) patients at the 3~5 stage, and to investigate the value of C-reactive protein to albumin ratio (CAR) and alkaline phosphatase to albumin ratio (APAR) in the prediction of CAC.  Methods  This was a cross-sectional and retrospective study on the 175 CKD patients at 3~5 stage. According to the CAC score, the patients were divided no CAC group (CAC score 0~10, n=88), and CAC group (CAC score ≥11, n=87). The differences of CAR and APAR were analyzed between the two groups. Spearman correlation was used to analyze the correlation between CAR, APAR and CAC. Binary logistic regression was used to analyze the risk factors of CAC. The receiver operating characteristic (ROC) curve was used to explore the values of CAR and APAR in the prediction of CAC.  Results  The detection rate of CAC was 49.7% in the 175 CKD patients at 3~5 stage. Spearman correlation analysis showed that CAC was positively correlated with CAR (r=0.416,     P<0.001) and APAR (r=0.226, P=0.003). Binary logistic regression analysis showed that age (OR=1.047, 95% CI: 1.012~1.083, P=0.007), diabetes (OR=0.132, 95% CI: 0.038~0.456, P=0.001), CAR(OR=16.332, 95% CI:2.415~110.447, P=0.004), and APAR (OR=1.500, 95% CI: 1.043~2.155, P=0.029) were the independent risk factors for CAC. ROC curve showed that the area under the curve were 0.765 (95% CI: 0.695~0.835, P<0.001) and 0.648 (95% CI: 25 0.567~0.730, P=0.001) for the prediction of CAC by CAR and APAR respectively.  Conclusion  ①The higher the values of CAR and APAR, the heavier the severity of coronary artery disease in the CKD patients at 3~5 stage. ②CAR and APAR can be used as the predictors for the severity of coronary artery disease in CKD patients at 3~5 stage.

Key words: Coronary artery calcification, C-reactive protein to albumin ratio, Alkaline phosphatase to albumin ratio, Chronic kidney disease