Van Berkel B, Van Ongeval C, Van Craenenbroeck AH, et al. - Chronic kidney disease (CKD) patients commonly develop breast artery calcification (BAC), which is associated with dismal cardiovascular outcomes. BAC score, kidney function, serum phosphate at baseline and vitamin K antagonist usage appear to be essential determinants of progression.

• This is a retrospective observational cohort study of 310 women (58.7 ± 10.8 yrs, Caucasian) with CKD in whom BAC was studied across stages of disease (CKDG2-5D n = 132; transplant recipients [Tx]: n = 178).

• BAC was observed in 34.7%, and its prevalence and BAC score rose along the progression of CKD.

• Older age, more cardiovascular disease, more inflammation, higher pulse pressure, and borderline higher prevalence of diabetes, and more often use of a vitamin K antagonist, all were evident in patients with BAC, in the whole cohort.

• A significantly lower progression rate of BAC was observed in Tx vs CKD G5D.

• Characteristics of progressors were: more inflammation, worse renal function, higher BAC score, higher serum phosphate level (Tx only) at baseline and more often received a vitamin K antagonist.

• A significantly worse major adverse cardiovascular event free survival was seen in Tx with BAC.