[Evaluation of coronary artery calcification in ESRD patients]

Abstract

Coronary artery calcification (CAC), observed in most end stage renal disease (ESRD) patients, has been reported to influence mortality and complications of cardiovascular diseases. Depend on the these reports, K/DOQI (Kidney Disease Outcomes Quality Initiative) guideline recommended to control serum Ca and phosphorus levels strictly in ESRD patients, in order to inhibit the progression of CAC. And then, we have been able to use new phosphate binder, sevelamer which dose not contain calcium and will able to use calcimimetics for secondary hyperparathyroidism as soon. Now, we should evaluate the diseases of bone as well as cardiovascular diseases according to the change of paradigms for renal osteodystrophy. It is undoubted that imaging methods play a main role on the management of CAC and coronary stenosis in end stage renal failure patients. Multidetector-row CT (MDCT) is a most useful imaging method, which has high temporal resolution and high spatial resolution. We may obtain adequate image quality for diagnosis and evaluate in 26 cases (87%), except for 4 cases not evaluated due to severe calcification. Therefore, this study suggested that 16-row MSCT is useful as a screening test for coronary angiography (CAG) even in dialysis patients.