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Phosphorus restriction and control of coronary calcification as assessed by electron beam tomography
1Tulane University School of Medicine, New Orleans, Louisiana 70112-2699, USA. praggi@tulane.edu
Insights
End-stage renal disease patients have high cardiovascular risks. Electron beam tomography accurately diagnoses cardiovascular calcification and monitors treatment effectiveness in these patients.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- End-stage renal disease (ESRD) patients exhibit disproportionately high cardiovascular morbidity and mortality.
- Traditional cardiovascular risk factors do not fully explain the severity of complications in ESRD.
Purpose of the Study:
- To review the role of calcium and phosphorus metabolism in cardiovascular complications of ESRD.
- To highlight the diagnostic utility of electron beam tomography (EBT) in assessing cardiovascular calcification in ESRD.
Main Methods:
- Review of current evidence on mineral metabolism and cardiovascular disease in ESRD.
- Focus on the application of electron beam tomography (EBT) for quantifying cardiovascular calcification.
- Assessment of EBT's ability to monitor treatment effects.
Main Results:
- Abnormalities in calcium and phosphorus metabolism are implicated in ESRD cardiovascular morbidity and mortality.
- Cardiovascular calcification, linked to hyperphosphatemia, is prevalent and prognostically significant in ESRD.
- EBT accurately quantifies calcification extent and progression, and evaluates treatment efficacy.
Conclusions:
- Electron beam tomography (EBT) provides accurate, noninvasive diagnosis of cardiovascular calcification in ESRD.
- EBT enables precise monitoring of medical interventions aimed at reducing cardiovascular calcification in ESRD patients.
Purpose Of Review:
Patients suffering from end-stage renal disease and undergoing dialysis demonstrate extremely elevated cardiovascular morbidity and mortality rates. Though the prevalence of traditional risk factors is very high, the extent and severity of cardiovascular complications seem disproportionate to the underlying risk profile.
Recent Findings:
A growing body of evidence indicates that abnormalities of calcium and phosphorus metabolism may play an important role in the morbidity and mortality of end-stage renal disease patients. Calcification of several cardiovascular structures, a likely complication of hyperphosphatemia and excessive calcium load, is both highly prevalent and extensive in end-stage renal disease patients and carries a negative prognostic weight. The extent of calcification can be accurately quantified with noninvasive radiological techniques such as electron beam tomography. Utilizing electron beam tomography in patients undergoing dialysis it has been possible to demonstrate the rapid progression of cardiovascular calcification and to gauge the effect of treatment provided to slow such process.
Summary:
The presence of deleterious cardiovascular calcification in end-stage renal disease can be diagnosed accurately and noninvasively with electron beam tomography. This technology also allows precise assessment of the effect of medical treatment for hyperphosphatemia on calcification of cardiovascular structures.