Detection of cardiac calcinosis in hemodialysis patients by whole-body scintigraphy with 99m-technetium methylene diphosphonate

A noninvasive method for the diagnosis of cardiac calcinosis, a life-threat ening complication in hemodialysis patients with end-stage renal disease (E SRD), has not, as yet, been firmly established. We tested whether whole bod y scanning with 99m-technetium methylene diphosphonate (MDP) might visualiz e cardiac calcinosis. In 19 consecutive chronic hemodialysis ESRD patients (13 males and 6 females, aged 40-81, mean 63 +/- 8 years) with cardiovascul ar disease [mitral annular calcinosis and/or calcified aortic valve (n = 4) , hemodialysis cardiomyopathy (n = 1), coronary artery disease (n = 9) and peripheral artery atherosclerotic disease (n = 6)], MDP uptake in the heart was compared to that in 7 non-ESRD controls with hyperparathyroidism due t o adenoma. Cardiac and lung field MDP uptake was confirmed in only 3 (16%) and 5 (26%) of the 19 ESRD subjects, respectively, but was absent in contro ls. Positive cardiac uptake was related to cardiac calcified complications (mobile intracardiac calcinosis, myocardial calcinosis and mitral annular c alcification) and the duration of hemodialysis (p = 0.015). While it was st atistically insignificant, subjects showing MDP uptake were elder and had h igher serum Ca or Ca x P product and lower intact parathyroid hormone level s. These results suggest that cardiac calcinosis in ESRD patients can be de tected noninvasively by myocardial scintigraphy with 99m-technetium MDP. Co pyright (C) 2000 S. Karger AG, Basel.