Evaluation of aortic calcification using a three-dimensional volume-rendering method in patients with end-stage kidney d
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ORIGINAL ARTICLE
Evaluation of aortic calcification using a three‑dimensional volume‑rendering method in patients with end‑stage kidney disease Hideki Fujii1 · Keiji Kono1 · Kentaro Watanabe1 · Shunsuke Goto1 · Tatsuya Nishii2 · Atsushi Kono2 · Shinichi Nishi1 Received: 6 September 2020 / Accepted: 16 October 2020 © The Japanese Society Bone and Mineral Research 2020
Abstract Introduction Very few studies have been performed to evaluate both the severity and site of aortic calcification (AC) in both end-stage kidney disease (ESKD) and diabetes mellitus (DM). The purpose of our study was to examine the utility of a newly developed three-dimensional (3D) visualization and quantification method compared with other methods to evaluate vascular calcification in ESKD patients with and without DM. Materials and methods Fifty patients with ESKD before initiating hemodialysis at our hospital were included in the present study. They were divided into the two groups, depending on the presence or absence of DM: Control group (n = 31) and DM group (n = 19). The volume and site of AC were evaluated via computed tomography (CT) scan using a 3D visualization and quantification method. Results Total calcification volume was significantly greater in the DM group than in the Control group. Calcification volume in the descending and abdominal aortas was greater in the DM group compared to the Control group. There were no significant differences in calcification volume in the aortic root, ascending aorta, and aortic arch. Calcification volume of the whole aorta, the descending aorta, and the abdominal aorta were each significantly correlated with age, diastolic blood pressure and pulse pressure. Conclusion This study using a 3D visualization and quantification method demonstrated that AC was more severe and occurred more frequently in the abdominal aorta in ESKD patients with DM compared to those without DM. This method would enable us to precisely evaluate the volume and distribution of AC. Keywords Aortic calcification volume · Aortic calcification site · Three-dimensional visualization and quantification method · Chronic kidney disease · Diabetes mellitus
Introduction Patients with chronic kidney disease (CKD), including those undergoing hemodialysis, have a remarkably increased prevalence for cardiovascular disease (CVD), with CVD also being a leading cause of death in these patients [1, 2]. The most frequently observed vascular lesion in these patients is vascular calcification (VC), and its presence makes it difficult to treat CVD in clinical settings. The pathophysiological * Hideki Fujii [email protected]‑u.ac.jp 1
Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7‑5‑2, Kusunoki‑cho, Chuo‑ku, Kobe, Hyogo 650‑0017, Japan
Division of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
2
mechanisms of the progression of VC are complex; however, mineral bone disorder and diabetes mellitus (DM) have been recognized to play key roles in the progression of VC, pa
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