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Progression of Medial Arterial Calcification in CKD

Shumila Manzoor1, Syed Ahmed1, Arshad Ali1

  • 1Renal Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.

Kidney International Reports
|November 20, 2018
PubMed

Insights

Medial arterial calcification progresses slowly in early chronic kidney disease (CKD) but accelerates in advanced stages and end-stage renal disease (ESRD). Mammography reliably tracks this calcification, with diabetes worsening progression in CKD and ESRD.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Radiology

Background:

  • Medial arterial calcification is prevalent in chronic kidney disease (CKD) and linked to adverse outcomes.
  • Quantifying calcification progression in relation to CKD severity and risk factors has been challenging due to a lack of reliable methods.

Purpose of the Study:

  • To assess the progression of medial arterial calcification in women with varying stages of CKD.
  • To evaluate the utility of mammography in measuring medial arterial calcification progression.
  • To identify risk factors influencing calcification progression in CKD patients.

Main Methods:

  • Mammography was used to measure medial arterial calcification in breast arteries, a surrogate for peripheral medial calcification.
  • The study included 60 control subjects and 137 women with CKD, categorized by estimated glomerular filtration rate (eGFR).
  • Progression rates were analyzed over time and correlated with CKD stage, diabetes, and post-kidney transplantation status.

Main Results:

  • Medial arterial calcification progression was linear and age-independent in controls (eGFR ≥ 90 ml/min/1.73 m²).
  • Progression increased significantly in advanced CKD (eGFR < 40 ml/min/1.73 m²) and accelerated markedly in end-stage renal disease (ESRD).
  • Diabetes significantly increased calcification progression in CKD and ESRD patients, while progression returned to control rates after kidney transplantation.

Conclusions:

  • Mammography provides a reliable and convenient method for quantifying medial arterial calcification progression.
  • Medial arterial calcification progression accelerates in advanced CKD and ESRD, highlighting the impact of kidney function decline.
  • Diabetes is a significant risk factor exacerbating medial arterial calcification in CKD and ESRD populations.
Abstract

Keywords:
ESRDdiabetesmammographyvascular calcification

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