Cardiovascular calcification in nondialyzed patients with chronic kidney disease

Wajeh Y Qunibi

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Chronic Kidney disease (CKD) has become a major health-care problem of global proportions. Progression to end-stage renal disease (ESRD), the need for renal replacement therapy, and the high annual death rate of dialysis patients are the most noticeable outcomes of CKD. Less appreciated, however, is the fact that most patients with CKD actually die mainly from cardiovascular disease, rather than progress to ESRD. Coronary artery calcification (CAC), a surrogate marker of atherosclerosis, is common in dialysis and CKD patients. Coronary artery calcium scores, as measured by ultrafast computed tomography, is an independent predictor of future cardiac events. Using this technique, several studies have documented extensive calcification in dialysis patients, a subject of several exhaustive reviews. Unfortunately, much less attention hasbeen paid to calcification in nondialyzed patients with CKD. In this review, I will emphasize the fact that CVC is common in patients with CKD not yet on dialysis, develops early in the course of CKD, and worsens with the decline in renal function particularly among diabetics who progressed to ESRD. I will also discuss the pathogenesis of CVC in CKD patients and highlight the lack of a major role for abnormalities of mineral metabolism in the pathogenesis of calcification in CKD patients. In addition to the high prevalence of traditional risk factors for CAD, the presence of proteinuria, reduced renal function, diabetic nephropathy, and the rate of progression to ESRD may represent the main uremia-related factors that increase the risk for calcification in CKD. Finally, I will review the protective role of inhibitors of calcification in CKD.

Original languageEnglish (US)
Pages (from-to)134-138
Number of pages5
JournalSeminars in Dialysis
Volume20
Issue number2
DOIs
StatePublished - Mar 2007

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Chronic Renal Insufficiency
Chronic Kidney Failure
Dialysis
Coronary Vessels
Kidney
Renal Replacement Therapy
Uremia
Diabetic Nephropathies
Proteinuria
Minerals
Atherosclerosis
Cardiovascular Diseases
Biomarkers
Tomography
Calcium
Delivery of Health Care
Mortality

ASJC Scopus subject areas

  • Nephrology

Cite this

Cardiovascular calcification in nondialyzed patients with chronic kidney disease. / Qunibi, Wajeh Y.

In: Seminars in Dialysis, Vol. 20, No. 2, 03.2007, p. 134-138.

Research output: Contribution to journalArticle

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