title: Non-invasive assessments of cardiovascular disease in patients with renal failure.
abstract: Vascular calcification is common in patients with chronic renal failure, and it may contribute to the very high mortality rate from cardiovascular causes in the end-stage renal disease population. Vascular calcification in chronic renal failure can arise from the calcification of the intimal layer of arteries as a result of atherosclerosis or from medial wall calcification due largely to alterations in mineral metabolism. Although several reports indicate that coronary artery calcification, as measured by electron-beam computed tomography, is quite common in patients with end-stage renal disease who are treated with dialysis, the clinical significance of these findings remain uncertain. In the general population, electron-beam computed tomography evidence of coronary calcification serves as a useful index of atherosclerotic burden and has value as a predictor of adverse coronary events. The relationship between coronary artery calcification and atherosclerotic cardiovascular disease has not been adequately studied, however, in patients with end-stage renal disease, and calcification scores in this population may reflect both intimal and medial wall calcification. Assessments using coronary angiography are needed to determine the diagnostic value of electron-beam computed tomography as a predictor of atherosclerotic cardiovascular disease in patients with chronic renal failure. Nevertheless, electron-beam computed tomography makes it possible to detect the presence and monitor the progression of coronary calcification in those undergoing long-term dialysis. The technique may provide important information about the impact of new therapeutic strategies aimed at reducing the risks of vascular calcification in those with chronic renal failure.
authors.affiliation: Division of Nephrology, Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA. wgoodman@ucla.edu
authors.forename: W G
authors.initials: WG
authors.lastname: Goodman
authors.forename: I B
authors.initials: IB
authors.lastname: Salusky
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D017023:Coronary Angiography; D006801:Humans; D051437:Renal Insufficiency / Q000150:complications* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed