title: Use of multidetector computed tomography for evaluating coronary artery disease in patients undergoing dialysis.
abstract: OBJECTIVE
  Cardiovascular disease is the most common cause of death in patients undergoing dialysis. The accuracy of multidetector computed tomography (MDCT) for detecting coronary disease has not been determined, and little information is available regarding the performance of MDCT in patients undergoing dialysis.
  
  
  METHODS
  Twenty-nine patients undergoing dialysis were analyzed and MDCT and coronary angiography (CAng) were performed consecutively. The coronary arteries were divided into four segments for analysis. We compared the significant stenosis lesions (≥50% luminal narrowing) identified by MDCT with those found by CAng. The total coronary artery calcium (CAC) score was determined by summing the individual lesion scores from each of the coronary branches.
  
  
  RESULTS
  One hundred and sixteen coronary artery branches in 29 patients were analyzed. The sensitivity, specificity, and positive and negative predictive values of MDCT for detecting significant coronary artery stenosis (≥50% stenosis) were 68%, 94%, 71% and 93%, respectively. The CAC scores were significantly higher in subjects with coronary artery disease (CAD) (514.0 ± 493.6 vs 254.3 ± 375.3, P = 0.05). The severe CAC score (>500) was related to the presence of significant CAD (P = 0.05) and the sensitivity and specificity for detecting significant CAD were 50% and 80%, respectively.
  
  
  CONCLUSIONS
  MDCT is a useful and non-invasive approach for detecting or excluding CAD in patients undergoing dialysis.
authors.affiliation: Department of Nephrology Cardiology Radiology, Soonchunhyang University Hospital, Bucheon, Korea.
authors.forename: Moo Yong
authors.initials: MY
authors.lastname: Park
authors.forename: Soo Jeong
authors.initials: SJ
authors.lastname: Choi
authors.forename: Jin Kuk
authors.initials: JK
authors.lastname: Kim
authors.forename: Seung Duk
authors.initials: SD
authors.lastname: Hwang
authors.forename: Jon
authors.initials: J
authors.lastname: Suh
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Seo
authors.forename: Dong Hun
authors.initials: DH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed