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Vascular imaging in chronic kidney disease

Bellasi, Antonioa; Raggi, Paolob

Current Opinion in Nephrology and Hypertension: July 2012 - Volume 21 - Issue 4 - p 382–388
doi: 10.1097/MNH.0b013e328354220c
MINERAL METABOLISM: Edited by Myles Wolf and David A. Bushinsky
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Purpose of review The chronic kidney disease (CKD) mineral bone disorder syndrome encompasses a number of metabolic, bone as well as vascular abnormalities of which vascular calcification is a prominent feature. Several noninvasive imaging techniques provide physicians with useful prognostic information beyond traditional cardiovascular and CKD-specific risk factors. We review the most recent evidence on vascular calcification screening as a tool for risk stratification in CKD patients.

Recent findings Cardiovascular aging is accelerated and is associated with a poor prognosis in CKD patients. Numerous traditional and nontraditional risk factors have been associated with this outcome. Imaging markers and serological risk factors do not carry the same prognostic information. In fact, whereas serum biomarkers reflect the risk to which the individual is exposed at the time of measurement, imaging markers represent the cumulative result of prolonged exposure to one or multiple risk factors. As such, they have often been demonstrated to be better outcome predictors than serological markers. In some cases, imaging markers have been suggested as desirable targets of therapy or to guide treatment individualization.

Summary Recent evidence suggests that cardiovascular imaging allows for cardiovascular risk stratification and treatment individualization in CKD patients.

aDivision of Nephrology, Sant’ Anna Hospital, Como, Italy

bDivision of Cardiology, Emory University, Atlanta, Georgia, USA

Correspondence to Paolo Raggi, MD, 1365 Clifton Road NE, Suite AT-504, Atlanta, GA 30322, USA. Tel: +1 404 778 5414; fax: +1 404 778 3540; e-mail: praggi@emory.edu

© 2012 Lippincott Williams & Wilkins, Inc.