[Cardiovascular risk in women with chronic renal failure: mammographic study of vascular calcifications].
OBJECTIVE
Vascular calcifications are markers of cardiovascular risk in patients with chronic renal failure, and 50% of the deaths in chronic renal failure are due to cardiovascular disease. We analyzed vascular calcifications at mammography in women with chronic renal failure, comparing the vascular calcifications seen at mammography and in skeletal x-ray examinations and analyzing their relation to cardiovascular disease and laboratory parameters.


METHODS
We studied the vascular calcifications seen at mammography and in skeletal x-ray examinations in 61 patients (45 dialysis and 16 pre-dialysis) and correlated them with age, time in dialysis, cardiovascular signs and symptoms, glycemia, arterial blood pressure, PTH, phosphorus, calcium, cholesterol (LDL/HDL), atherogenic index, triglycerides, and inflammatory markers. The statistical analysis was performed using SPSS 11.0 .


RESULTS
Vascular calcifications were found in 55.7% of patients at mammography and in a similar percentage in skeletal x-ray examinations; 18% of the women had vascular calcifications at mammography but not in skeletal x-ray examinations, whereas 19.6% had vascular calcifications in skeletal x-ray examinations but not at mammography. Vascular calcifications were found in 60% of the women undergoing dialysis and in 30% of the women who had yet to undergo dialysis. Women with vascular calcifications at mammography were older (p < 0.05), had higher blood glucose (p < 0.05), PTH, phosphorus, and LDL cholesterol. They also had higher ferritin and C-reactive protein levels (p < 0.05) and had more cardiovascular events (myocardial infarction, with p < 0.05). Their HDL and albumin levels (p < 0.05) and blood pressure were lower than in women without vascular calcifications at mammography.


CONCLUSIONS
The presence of vascular calcifications at mammography is associated to increased cardiovascular risk, and this increase is already evident before dialysis. Early diagnosis of cardiovascular risk should help reduce morbidity and mortality in these patients. The study of vascular calcifications at mammography complements skeletal x-ray examinations. Vascular calcifications at mammography are associated to abnormalities in bone metabolism, dyslipemia, and chronic inflammation.
Canabal
A
A
Servicio de Radiodiagnóstico. Hospital San Juan de Dios del Aljarafe. Bormujos. Sevilla. España. a.canabal@telefonica.net
Sabate
J
J
Salgueira
M
M
Palma
A
A
D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000378:metabolism; D002114:Calcinosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000097:blood / Q000000981:diagnostic imaging*; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy; D008055:Lipids / Q000097:blood; D008327:Mammography; D010281:Parathyroid Hormone / Q000097:blood; D014652:Vascular Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology
D015415:Biomarkers; D008055:Lipids; D010281:Parathyroid Hormone