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[Cardiovascular risk in women with chronic renal failure: mammographic study of vascular calcifications]
A Canabal1, J Sabate, M Salgueira
1Servicio de Radiodiagnóstico. Hospital San Juan de Dios del Aljarafe. Bormujos. Sevilla. España. a.canabal@telefonica.net
Insights
Vascular calcifications detected via mammography indicate heightened cardiovascular risk in chronic renal failure patients, even before dialysis. Early detection aids in reducing mortality and morbidity associated with kidney disease.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Vascular calcifications are significant indicators of cardiovascular disease (CVD) risk in patients with chronic renal failure (CRF).
- CVD accounts for approximately 50% of all deaths among individuals with CRF.
Purpose of the Study:
- To analyze vascular calcifications detected through mammography in women with CRF.
- To compare mammography findings with skeletal X-ray examinations.
- To investigate the association between vascular calcifications and CVD, as well as various laboratory parameters.
Main Methods:
- Vascular calcifications were assessed using mammography and skeletal X-rays in 61 women (45 on dialysis, 16 pre-dialysis).
- Correlations were examined with age, dialysis duration, CVD symptoms, blood glucose, blood pressure, parathyroid hormone (PTH), phosphorus, calcium, lipids (LDL/HDL), triglycerides, and inflammatory markers.
- Statistical analysis was performed using SPSS 11.0.
Main Results:
- Vascular calcifications were observed in 55.7% of patients via mammography and similarly in skeletal X-rays.
- A notable percentage of women showed calcifications in one imaging modality but not the other.
- Women with mammography-detected vascular calcifications were older and exhibited higher blood glucose, PTH, phosphorus, LDL cholesterol, ferritin, and C-reactive protein levels. They also had a higher incidence of cardiovascular events and lower HDL and albumin levels.
- Blood pressure was lower in women with vascular calcifications at mammography.
Conclusions:
- Mammography can identify vascular calcifications, signaling increased cardiovascular risk in CRF patients, even in pre-dialysis stages.
- Early identification of CVD risk factors is crucial for mitigating morbidity and mortality in this population.
- Mammography findings for vascular calcifications complement skeletal X-ray assessments and are linked to bone metabolism abnormalities, dyslipidemia, and chronic inflammation.
Objectives:
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.
Materials And 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.
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