Vascular Calcification in Predialysis CKD

Coronary artery calcification score and common iliac artery calcification score in non‐dialysis CKD patients

“…Our results support the hypothesis that the uraemic milieu promotes VC . In this study, age and the presence of DM seemed to be common elements that were associated with both the CACS and IACS, which is consistent with previous reports . However, some variables that were associated with one score but not the other were also found in this study.…”

“…18 The risk factors for VC in CKD include traditional risk factors, such as older age, DM, dyslipidaemia, and inflammation, as well as novel risk factors that are more specific to patients with CKD, such as hyperphosphataemia, uraemic toxins, and dialysis vintage. 1,19 Medial calcification appears to be the parallel occurrence of a phenotype switch of vascular smooth muscle cell and local inflammation, in an environment with changed profiles of calcification-regulating humoral factors, which include calcium and phosphate itself. 11,20 More so than in the medial layer, intimal calcification appears to be secondary phenomenon of inflammation.…”

“…Vascular calcification (VC) is associated with the risk of cardiovascular mortality and is highly prevalent in patients with chronic kidney disease (CKD). 1 Intimal calcification is an indicator of atherosclerosis, and medial calcification, as represented by Mönckeberg medial sclerosis, is an indicator of arteriosclerosis. [2][3][4][5] CKD patients exhibit both intimal and medial calcification.…”

“…4 Compared with elastic arteries, such as the aorta, muscular arteries distribute blood to various organs, and are more susceptible to medial calcification. 1 It is reported that the Adragao score (AS) is useful for evaluating VC in muscular (radial and digital) or predominantly muscular (iliac and femoral) arteries, which are more susceptible to medial calcification, 7,8 and the AS has been confirmed to be an independent predictor of mortality and hospital admission in CKD patients. 8 Thus, assessing both the CACS and the common iliac artery calcification score (IACS): predominantly muscular artery calcification score, in CKD patients using the same thoracicoabdominal MDCT images might provide further information about VC in CKD patients.…”

“…However, the CACS is not able to distinguish between intimal (atherosclerotic) and medial (arteriosclerotic) calcification, which result in different cardiovascular insults (acute coronary syndrome and myocardial infarction vs. left ventricular hypertrophy and cardiac failure) . Compared with elastic arteries, such as the aorta, muscular arteries distribute blood to various organs, and are more susceptible to medial calcification . It is reported that the Adragao score (AS) is useful for evaluating VC in muscular (radial and digital) or predominantly muscular (iliac and femoral) arteries, which are more susceptible to medial calcification, and the AS has been confirmed to be an independent predictor of mortality and hospital admission in CKD patients .…”