Skip to main content
Top
Published in: Journal of Nuclear Cardiology 6/2021

01-12-2021 | Chronic Kidney Disease | EDITORIAL

Choosing between anatomy and function is not always evident for the heart of end-stage renal disease patients. How low can we go?

Author: Amalia Peix

Published in: Journal of Nuclear Cardiology | Issue 6/2021

Login to get access

Abstract

Patients with chronic kidney disease (CKD) are at a very high risk of adverse cardiovascular events. In CKD patients, vascular calcification is more prevalent, appears at an earlier age, and is more severe than in the general population. CKD physiology rather than the effects of dialysis is the primary driver of microvascular disease in these patients. Considering the significant morbidity and mortality attributable to cardiovascular disease in the CKD population, risk stratification remains an important challenge. Topics such as function vs anatomy to properly risk stratify these patients, as well as future perspectives on non-invasive techniques, will be addressed.
Literature
1.
go back to reference Sarnak MJ, Amann K, Bangalore S, Cavalcante JL, Charytan DM, Craig JC, et al. Chronic kidney disease and coronary artery disease. J Am Coll Cardiol 2019;74:1823-38.CrossRef Sarnak MJ, Amann K, Bangalore S, Cavalcante JL, Charytan DM, Craig JC, et al. Chronic kidney disease and coronary artery disease. J Am Coll Cardiol 2019;74:1823-38.CrossRef
2.
go back to reference Lemos MM, Jancikic AD, Sanches FM, Christofalo DM, Ajzen SA, Carvalho AB, et al. Intima-media thickness is associated with inflammation and traditional cardiovascular risk factors in non-dialysis-dependent patients with chronic kidney disease. Nephron Clin Pract 2010;115:c189-94.CrossRef Lemos MM, Jancikic AD, Sanches FM, Christofalo DM, Ajzen SA, Carvalho AB, et al. Intima-media thickness is associated with inflammation and traditional cardiovascular risk factors in non-dialysis-dependent patients with chronic kidney disease. Nephron Clin Pract 2010;115:c189-94.CrossRef
3.
go back to reference Adeseun GA, Xie D, Wang X, Joffe MM, Mohler ER, Townsend RR, et al. Carotid plaque, carotid intima-media thickness, and coronary calcification equally discriminate prevalent cardiovascular disease in kidney disease. Am J Nephrol 2012;36:342-7.CrossRef Adeseun GA, Xie D, Wang X, Joffe MM, Mohler ER, Townsend RR, et al. Carotid plaque, carotid intima-media thickness, and coronary calcification equally discriminate prevalent cardiovascular disease in kidney disease. Am J Nephrol 2012;36:342-7.CrossRef
4.
go back to reference London GM, Guerin AP, Marchais SJ, Metivier F, Pannier B, Adda H. Arterial media calcification in end-stage renal disease: Impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 2003;18:1731-40.CrossRef London GM, Guerin AP, Marchais SJ, Metivier F, Pannier B, Adda H. Arterial media calcification in end-stage renal disease: Impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 2003;18:1731-40.CrossRef
5.
go back to reference Nakamura S, Ishibashi-Ueda H, Niizuma S, Yoshihara F, Horio T, Kawano Y. Coronary calcification in patients with chronic kidney disease and coronary artery disease. Clin J Am Soc Nephrol 2009;4:1892-900.CrossRef Nakamura S, Ishibashi-Ueda H, Niizuma S, Yoshihara F, Horio T, Kawano Y. Coronary calcification in patients with chronic kidney disease and coronary artery disease. Clin J Am Soc Nephrol 2009;4:1892-900.CrossRef
6.
go back to reference Nolan RL, Morton AR, Pickett W. Prevalence and associations of coronary artery calcification in patients with stages 3 to 5 CKD without cardiovascular disease. Am J Kidney Dis 2008;52:849-58.CrossRef Nolan RL, Morton AR, Pickett W. Prevalence and associations of coronary artery calcification in patients with stages 3 to 5 CKD without cardiovascular disease. Am J Kidney Dis 2008;52:849-58.CrossRef
7.
go back to reference Cardellini M, Rovella V, Scimeca M, Anemona L, Bischetti S, Casella S, et al. Chronic kidney disease is linked to carotid nodular calcification, an unstable plaque not correlated to inflammation. Aging Dis 2019;10:71-81.CrossRef Cardellini M, Rovella V, Scimeca M, Anemona L, Bischetti S, Casella S, et al. Chronic kidney disease is linked to carotid nodular calcification, an unstable plaque not correlated to inflammation. Aging Dis 2019;10:71-81.CrossRef
8.
go back to reference Schlieper G, Aretz A, Verberckmoes SC, Krüger T, Behets GJ, Ghadimi R, et al. Ultrastructural analysis of vascular calcifications in uremia. J Am Soc Nephrol 2010;21:689-96.CrossRef Schlieper G, Aretz A, Verberckmoes SC, Krüger T, Behets GJ, Ghadimi R, et al. Ultrastructural analysis of vascular calcifications in uremia. J Am Soc Nephrol 2010;21:689-96.CrossRef
9.
go back to reference Robinson J, Tan AU, Wilensky RL, Matthai W, Munoz M, Rosas SE. Electron-beam computerized tomography correlates with coronary angiogram in chronic kidney disease patients. Am J Nephrol 2007;27:247-52.CrossRef Robinson J, Tan AU, Wilensky RL, Matthai W, Munoz M, Rosas SE. Electron-beam computerized tomography correlates with coronary angiogram in chronic kidney disease patients. Am J Nephrol 2007;27:247-52.CrossRef
11.
go back to reference Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000;342:1478-83.CrossRef Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000;342:1478-83.CrossRef
12.
go back to reference Folsom AR, Kronmal RA, Detrano RC, O’Leary DH, Bild DE, Bluemke DA, et al. Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: The Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med 2008;168:1333-9.CrossRef Folsom AR, Kronmal RA, Detrano RC, O’Leary DH, Bild DE, Bluemke DA, et al. Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: The Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med 2008;168:1333-9.CrossRef
13.
go back to reference Spacil J, Ceska R, Petrasek J, Sobra J. The effect of four-year hypolipidaemic treatment on the intimal thickness of the common carotid artery in patients with familiar hyperlipidaemia. Int Angiol 1999;18:313-9.PubMed Spacil J, Ceska R, Petrasek J, Sobra J. The effect of four-year hypolipidaemic treatment on the intimal thickness of the common carotid artery in patients with familiar hyperlipidaemia. Int Angiol 1999;18:313-9.PubMed
14.
go back to reference Sillesen H, Muntendam P, Adourian A, Entrekin R, Garcia M, Falk E, et al. Carotid plaque burden as a measure of subclinical atherosclerosis: Comparison with other tests for subclinical arterial disease in the high risk plaque BioImage Study. J Am Coll Cardiol Img 2012;5:681-9.CrossRef Sillesen H, Muntendam P, Adourian A, Entrekin R, Garcia M, Falk E, et al. Carotid plaque burden as a measure of subclinical atherosclerosis: Comparison with other tests for subclinical arterial disease in the high risk plaque BioImage Study. J Am Coll Cardiol Img 2012;5:681-9.CrossRef
15.
16.
go back to reference Matsuoka M, Iseki K, Tamashiro M, Fujimoto N, Higa N, Touma T, et al. Impact of high coronary artery calcification score (CACS) on survival in patients on chronic hemodialysis. Clin Exp Nephrol 2004;8:54-8.CrossRef Matsuoka M, Iseki K, Tamashiro M, Fujimoto N, Higa N, Touma T, et al. Impact of high coronary artery calcification score (CACS) on survival in patients on chronic hemodialysis. Clin Exp Nephrol 2004;8:54-8.CrossRef
17.
go back to reference Block GA, Raggi P, Bellasi A, Kooienga L, Spiegel DM. Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients. Kidney Int 2007;71:438-41.CrossRef Block GA, Raggi P, Bellasi A, Kooienga L, Spiegel DM. Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients. Kidney Int 2007;71:438-41.CrossRef
18.
go back to reference Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008;358:1336-45.CrossRef Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008;358:1336-45.CrossRef
19.
go back to reference Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 2004;291:210-5.CrossRef Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 2004;291:210-5.CrossRef
20.
go back to reference Greenland P, Bonow RO, Brundage BH, Budoff MJ, Eisenberg MJ, Grundy SM, et al. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: A report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography) developed in collaboration with the Society of Atherosclerosis Imaging and Prevention and the Society of Cardiovascular Computed Tomography. J Am Coll Cardiol 2007;49:378-402.CrossRef Greenland P, Bonow RO, Brundage BH, Budoff MJ, Eisenberg MJ, Grundy SM, et al. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: A report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography) developed in collaboration with the Society of Atherosclerosis Imaging and Prevention and the Society of Cardiovascular Computed Tomography. J Am Coll Cardiol 2007;49:378-402.CrossRef
21.
go back to reference Kato A, Takita T, Maruyama Y, Kumagai H, Hishida A. Impact of carotid atherosclerosis on long-term mortality in chronic hemodialysis patients. Kidney Int 2003;64:1472-9.CrossRef Kato A, Takita T, Maruyama Y, Kumagai H, Hishida A. Impact of carotid atherosclerosis on long-term mortality in chronic hemodialysis patients. Kidney Int 2003;64:1472-9.CrossRef
22.
go back to reference Ekart R, Hojs R, Hojs-Fabjan T, Balon BP. Predictive value of carotid intima media thickness in hemodialysis patients. Artif Organs 2005;29:615-9.CrossRef Ekart R, Hojs R, Hojs-Fabjan T, Balon BP. Predictive value of carotid intima media thickness in hemodialysis patients. Artif Organs 2005;29:615-9.CrossRef
23.
go back to reference Zoungas S, Cameron JD, Kerr PG, Wolfe R, Muske C, McNeil JJ, et al. Association of carotid intima-medial thickness and indices of arterial stiffness with cardiovascular disease outcomes in CKD. Am J Kidney Dis 2007;50:622-30.CrossRef Zoungas S, Cameron JD, Kerr PG, Wolfe R, Muske C, McNeil JJ, et al. Association of carotid intima-medial thickness and indices of arterial stiffness with cardiovascular disease outcomes in CKD. Am J Kidney Dis 2007;50:622-30.CrossRef
24.
go back to reference Gaspar A, Watanabe R, Montebello M, Fernandes ME. Evaluation of intima-media thickness in patients with chronic kidney disease not on dialysis: A prospective study of 24 months. J Bras Nefrol 2014;36:35-41.CrossRef Gaspar A, Watanabe R, Montebello M, Fernandes ME. Evaluation of intima-media thickness in patients with chronic kidney disease not on dialysis: A prospective study of 24 months. J Bras Nefrol 2014;36:35-41.CrossRef
25.
go back to reference Hamczyk MR, Nevado RM, Barettino A, Fuster V, Andrés V. Biological versus chronological aging. J Am Coll Cardiol 2020;75:919-30.CrossRef Hamczyk MR, Nevado RM, Barettino A, Fuster V, Andrés V. Biological versus chronological aging. J Am Coll Cardiol 2020;75:919-30.CrossRef
26.
go back to reference Einstein AJ, Johnson LL, Bokhari S, Son J, Thompson RC, Bateman TM, et al. Agreement of visual estimation of coronary artery calcium from low-dose CT attenuation correction scans in hybrid PET/CT and SPECT/CT with standard Agatston score. J Am Coll Cardiol 2010;56:1914-21.CrossRef Einstein AJ, Johnson LL, Bokhari S, Son J, Thompson RC, Bateman TM, et al. Agreement of visual estimation of coronary artery calcium from low-dose CT attenuation correction scans in hybrid PET/CT and SPECT/CT with standard Agatston score. J Am Coll Cardiol 2010;56:1914-21.CrossRef
27.
go back to reference Xie X, Zhao Y, de Bock GH, de Jong PA, Mali WP, Oudkerk M, et al. Validation and prognosis of coronary artery calcium scoring in nontriggered thoracic computed tomography: Systematic review and meta-analysis. Circ Cardiovasc Imaging 2013;6:514-21.CrossRef Xie X, Zhao Y, de Bock GH, de Jong PA, Mali WP, Oudkerk M, et al. Validation and prognosis of coronary artery calcium scoring in nontriggered thoracic computed tomography: Systematic review and meta-analysis. Circ Cardiovasc Imaging 2013;6:514-21.CrossRef
28.
go back to reference Dumer S, Einstein A. Coronary calcium scoring of CT attenuation correction scans: Automatic, manual, or visual? J Nucl Cardiol 2018;25:2144-7.CrossRef Dumer S, Einstein A. Coronary calcium scoring of CT attenuation correction scans: Automatic, manual, or visual? J Nucl Cardiol 2018;25:2144-7.CrossRef
29.
go back to reference Charytan DM, Skali H, Shah NR, Veeranna V, Cheezum MK, Taqueti VR, et al. Coronary flow reserve is predictive of the risk of cardiovascular death regardless of chronic kidney disease stage. Kidney Int 2018;93:501-9.CrossRef Charytan DM, Skali H, Shah NR, Veeranna V, Cheezum MK, Taqueti VR, et al. Coronary flow reserve is predictive of the risk of cardiovascular death regardless of chronic kidney disease stage. Kidney Int 2018;93:501-9.CrossRef
30.
go back to reference Murthy VL, Naya M, Foster CR, Hainer J, Gaber M, Dorbala S, et al. Coronary vascular dysfunction and prognosis in patients with chronic kidney disease. JACC Cardiovasc Imaging 2012;5:1025-34.CrossRef Murthy VL, Naya M, Foster CR, Hainer J, Gaber M, Dorbala S, et al. Coronary vascular dysfunction and prognosis in patients with chronic kidney disease. JACC Cardiovasc Imaging 2012;5:1025-34.CrossRef
31.
go back to reference Kidney Disease: Improving Global Outcomes Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant 2009;9:S1-155. Kidney Disease: Improving Global Outcomes Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant 2009;9:S1-155.
32.
go back to reference Kidney Disease: Improving Global Outcomes (KDIGO) Lipid Work Group. KDIGO clinical practice guideline for lipid management in chronic kidney disease. Kidney Int Suppl 2013;3:259-305.CrossRef Kidney Disease: Improving Global Outcomes (KDIGO) Lipid Work Group. KDIGO clinical practice guideline for lipid management in chronic kidney disease. Kidney Int Suppl 2013;3:259-305.CrossRef
34.
go back to reference Anker SD, Gillespie IA, Eckardt KU, Kronenberg F, Richards S, Drueke TB, for the ARO Steering Committee, et al. Development and validation of cardiovascular risk scores for haemodialysis patients. Int J Cardiol 2016;216:68-77.CrossRef Anker SD, Gillespie IA, Eckardt KU, Kronenberg F, Richards S, Drueke TB, for the ARO Steering Committee, et al. Development and validation of cardiovascular risk scores for haemodialysis patients. Int J Cardiol 2016;216:68-77.CrossRef
35.
go back to reference Valdivielso JM, Rodríguez-Puyol D, Pascual J, Barrios C, Bermúdez-López M, Sánchez-Niño MD, et al. Atherosclerosis in chronic kidney disease: More, less, or just different? Arterioscler Thromb Vasc Biol 2019;39:1938-66.CrossRef Valdivielso JM, Rodríguez-Puyol D, Pascual J, Barrios C, Bermúdez-López M, Sánchez-Niño MD, et al. Atherosclerosis in chronic kidney disease: More, less, or just different? Arterioscler Thromb Vasc Biol 2019;39:1938-66.CrossRef
36.
go back to reference Fiz F, Morbelli S, Piccardo A, Bauckneht M, Ferrarazzo G, Pestarino E, et al. 18F-NaF uptake by atherosclerotic plaque on PET/CT imaging: Inverse correlation between calcification density and mineral metabolic activity. J Nucl Med 2015;56:1019-23.CrossRef Fiz F, Morbelli S, Piccardo A, Bauckneht M, Ferrarazzo G, Pestarino E, et al. 18F-NaF uptake by atherosclerotic plaque on PET/CT imaging: Inverse correlation between calcification density and mineral metabolic activity. J Nucl Med 2015;56:1019-23.CrossRef
37.
go back to reference Rosa GM, Bauckneht M, Masoero G, Mach F, Quercioli A, Seitun S, et al. The vulnerable coronary plaque: Update on imaging technologies. Thromb Haemost 2013;110:706-22.CrossRef Rosa GM, Bauckneht M, Masoero G, Mach F, Quercioli A, Seitun S, et al. The vulnerable coronary plaque: Update on imaging technologies. Thromb Haemost 2013;110:706-22.CrossRef
38.
go back to reference Joshi NV, Vesey AT, Williams MC, Shah AS, Calvert PA, Craighead FH, et al. 18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: A prospective clinical trial. Lancet 2014;383:705-13.CrossRef Joshi NV, Vesey AT, Williams MC, Shah AS, Calvert PA, Craighead FH, et al. 18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: A prospective clinical trial. Lancet 2014;383:705-13.CrossRef
40.
go back to reference Figueroa AL, Abdelbaky A, Truong QA, Corsini E, MacNabb MH, Lavender ZR, et al. Measurement of arterial activity on routine FDG PET/CT images improves prediction of risk of future CV events. JACC Cardiovasc Imaging 2013;6:1250-9.CrossRef Figueroa AL, Abdelbaky A, Truong QA, Corsini E, MacNabb MH, Lavender ZR, et al. Measurement of arterial activity on routine FDG PET/CT images improves prediction of risk of future CV events. JACC Cardiovasc Imaging 2013;6:1250-9.CrossRef
41.
go back to reference Fayad ZA, Mani V, Woodward M, Kallend D, Abt M, Burgess T, dal- PLAQUE Investigators, et al. Safety and efficacy of dalcetrapib on atherosclerotic disease using novel non-invasive multimodality imaging (dal-PLAQUE): A randomised clinical trial. Lancet 2011;378:1547-59.CrossRef Fayad ZA, Mani V, Woodward M, Kallend D, Abt M, Burgess T, dal- PLAQUE Investigators, et al. Safety and efficacy of dalcetrapib on atherosclerotic disease using novel non-invasive multimodality imaging (dal-PLAQUE): A randomised clinical trial. Lancet 2011;378:1547-59.CrossRef
Metadata
Title
Choosing between anatomy and function is not always evident for the heart of end-stage renal disease patients. How low can we go?
Author
Amalia Peix
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 6/2021
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-020-02118-z

Other articles of this Issue 6/2021

Journal of Nuclear Cardiology 6/2021 Go to the issue