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Author Notes:

Correspondence: Dr. W. Charles O'Neill, Renal Division, Department of Medicine, Emory University School of Medicine, 1639 Pierce Drive, Atlanta, GA 30322. Phone: 404-727-3922; Fax: 404-727-3425; Email: woneill@emory.edu.

There are no conflicts of interest to disclose.

Subjects:

Breast Arterial Calcification: A Marker of Medial Vascular Calcification in Chronic Kidney Disease

Tools:

Journal Title:

Clinical Journal of the American Society of Nephrology

Volume:

Volume 6, Number 2

Publisher:

, Pages 377-382

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background and objectives: Because previous studies have not distinguished between intimal (atherosclerotic) and medial vascular calcification, the prevalence and clinical significance of either condition in chronic or end-stage kidney disease (CKD or ESKD) are unknown. We hypothesized that breast arterial calcification (BAC) is exclusively medial and that mammography can serve as a useful marker of generalized medial calcification in CKD and ESKD. Design, setting, participants, & measurements: Arterial calcification was identified histologically in breast tissue or visually in mammograms and radiographs of extremities from patients with CKD or ESKD. Results: Medial calcification but no intimal calcification was present in all 16 specimens from patients with CKD or ESKD. In 71 women with ESKD, BAC was present on mammograms in 63% compared with 17% in women without renal insufficiency matched for age, race, and diabetes (P < 0.001). Age and ESKD duration were significant, independent predictors of BAC. BAC was also present in 36% of mammograms from the same patients performed 5.5 ± 0.7 years before the onset of ESKD (P < 0.05 versus control) but in only 14% of patients with stage 3 CKD. Comparison of mammograms and extremity radiographs revealed that BAC was present in over 90% of patients with peripheral arterial calcification (PAC), and PAC was observed in less than 6% of patients without BAC. Conclusions: BAC is a specific and useful marker of medial vascular calcification in CKD, and its prevalence is markedly increased in ESKD and advanced CKD.

Copyright information:

© 2011 by the American Society of Nephrology

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