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Coronary Artery Calcium Assessment in CKD: Utility in Cardiovascular Disease Risk Assessment and Treatment?
- Source :
-
American journal of kidney diseases : the official journal of the National Kidney Foundation [Am J Kidney Dis] 2015 Jun; Vol. 65 (6), pp. 937-48. Date of Electronic Publication: 2015 Mar 06. - Publication Year :
- 2015
-
Abstract
- Coronary artery calcification (CAC) is a strong predictor of cardiovascular event rates in the general population, and scoring with multislice computed tomography commonly is used to improve risk stratification beyond clinical variables. CAC is accelerated in chronic kidney disease, but this occurs as a result of 2 distinct pathologic processes that result in medial (arteriosclerosis) and intimal (atherosclerosis) deposition. Although there are data that indicate that very high CAC scores may be associated with increased risk of death in hemodialysis, average CAC scores in most patients are elevated at a level at which discriminatory power may be reduced. There is a lack of data to guide management strategies in these patients based on CAC scores. There are even fewer data available for nondialysis patients, and it is uncertain whether CAC score confers an elevated risk of premature cardiovascular morbidity and mortality in such patients. In this article, we review the evidence regarding the utility of CAC score for noninvasive cardiovascular risk assessment in individuals with chronic kidney disease, using a clinical vignette that highlights some of the limitations in using CAC score and considerations in risk stratification.<br /> (Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Asymptomatic Diseases
Cardiovascular Diseases complications
Cardiovascular Diseases diagnostic imaging
Cardiovascular Diseases therapy
Coronary Angiography
Coronary Artery Disease complications
Coronary Artery Disease therapy
Humans
Male
Middle Aged
Multidetector Computed Tomography
Risk Assessment
Vascular Calcification complications
Vascular Calcification therapy
Coronary Artery Disease diagnostic imaging
Diabetic Nephropathies complications
Kidney Failure, Chronic complications
Vascular Calcification diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6838
- Volume :
- 65
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- American journal of kidney diseases : the official journal of the National Kidney Foundation
- Publication Type :
- Academic Journal
- Accession number :
- 25754074
- Full Text :
- https://doi.org/10.1053/j.ajkd.2015.01.012