{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:57:48Z","timestamp":1790683068011,"version":"4.1.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Coronary artery calcification (CAC) progresses rapidly in chronic kidney disease (CKD), but its trajectories across stages and nonlinear relationships with serum magnesium and parathyroid hormone (PTH) remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated 800 CKD patients stratified into four groups (stages 1\u20132, 3, 4\u20135, and dialysis) over a median follow-up of 20.5 months using serial chest CT scans. Linear mixed-effects models, restricted cubic splines, and LASSO regression were applied to analyze trajectories, nonlinear relationships, and construct a predictive model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The annualized rate of CAC progression increased significantly with advancing CKD stages (8.5%, 13.2%, 22.8%, and 29.5%\/year, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Serum magnesium exhibited an L-shaped nonlinear relationship with rapid CAC progression (inflection point: 0.82 mmol\/L), while PTH showed a J-shaped relationship (inflection point: 120 pg\/mL). Uric acid was linearly and positively correlated. A 7-factor LASSO-derived prognostic model demonstrated robust performance, yielding a C-statistic of 0.802 (95% CI: 0.772-0.832) and good calibration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, CAC progression accelerates as renal function declines, peaking in dialysis patients. Low magnesium (&amp;lt;0.82 mmol\/L) and high PTH (120 pg\/mL) are key nonlinear risk factors. The resulting predictive model provides clinical utility for stratified cardiovascular risk management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1910302","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:10Z","timestamp":1789446430000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Progression of coronary artery calcification in chronic kidney disease: nonlinear associations with serum magnesium and parathyroid hormone"],"prefix":"10.3389","volume":"13","author":[{"given":"Yutong","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhao","family":"Qiu","sequence":"additional","affiliation":[{"name":"School of Computer Science and Technology, Chongqing University of Posts and Telecommunications","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinglan","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifeng","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yindeng","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, 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