Using vertebral bone densitometry to determine aortic calcification in patients with chronic kidney disease

Nephrology
Nigel D ToussaintPeter G Kerr

Abstract

Vascular calcification (VC) is a major contributor to increased cardiovascular (CV) disease in chronic kidney disease (CKD) and an independent predictor of mortality. VC is inversely correlated with bone mineral density (BMD). Screening for VC may be useful to determine those at greater CV risk and dual-energy X-ray absorptiometry (DXA) may have a dual role in providing VC measurement as well as BMD. We report cross-sectional data on 44 patients with CKD stages 3-4 and aim to determine and validate measurement of VC using DXA. Patients had computed tomography (CT) of abdominal aorta and DXA of lateral lumbar spine, to determine both aortic VC and BMD. Semi-quantitative measurement of VC from DXA was determined (blinded) using previously validated 8- and 24-point scales, and compared with VC from CT. BMD determination from L2 to L4 vertebrae on CT was compared with DXA-reported BMD. Patients 66% male, 57% diabetic, had mean age 63.4 years and mean estimated glomerular filtration rate 31.4 +/- 12 mL/min. Aortic VC was present in 95% on CT, mean 564.9 +/- 304 Hounsfield units (HU). Aortic VC was seen in 68% on lateral DXA, mean scores 5.1 +/- 5.9 and 1.9 +/- 1.9 using 24- and 8-point scales, respectively. Strong correlation of VC ...Continue Reading

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