Imaging of cardiovascular calcifications with electron beam tomography in hemodialysis patients

Cardiovascular disease is the leading cause of death in Western countries a nd it is especially frequent in dialysis patients. Although for a long time physicians have been mainly focused on the severity of luminal coronary st enosis, atherosclerosis starts and expands in the thickness of the arterial wall much before it extends into the vessel lumen. Indeed, most acute coro nary events occur in patients with non-obstructive luminal disease. On path ologic examination, patients with end-stage renal disease (ESRD) show large r and more extensively calcified atherosclerotic lesions than non-dialysis patients. Recent evidence shows that even very young dialysis patients show premature calcification of the coronary arteries. Therefore, early detecti on of atherosclerotic disease with a non-invasive imaging technology, such as electron beam tomography (EBT), may provide an opportunity to modify the disease course and reduce the related event rate. (C) 2001 by the National Kidney Foundation, Inc.