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Nephrology: Vascular Calcification in Chronic Kidney Disease Individuals

Vascular calcification is common in non-dialysis individuals with chronic kidney disease and a certain type, medial calcification, might be deadly. New studies find that 79% of individuals have vascular calcification and in 47% it is prominent. In particular, vascular calcification occurring in the medial portion of muscular arteries was associated with twice the risk of all-cause mortality and three times the risk of cardiovascular mortality. Vascular calcification did not predict chronic kidney disease progression. The existence of vascular calcification appraised by radiographs of the hand and pelvis is an independent and robust predictor of all-cause and cardiovascular mortality and the period of hospitalization in individuals with non-dialysis chronic kidney disease, supporting the KDIGO [Kidney Disease Improving Global Outcomes] guidelines on the use of simple radiology for screening vascular calcification in patients with chronic kidney disease. The association between vascular calcification and the risk of morbidity and mortality is a common finding in individuals on dialysis. Results showed that this association commence at earlier stages of chronic kidney disease. The recent outcomes show that vascular calcification starts earlier in the course of chronic kidney disease, which suggests that it may be potentially modifiable long before the initiation of dialysis. Cardiovascular mortality is unacceptably high in chronic kidney disease patients, and vascular calcification likely plays a large role either as the cause or as the marker of this mortality.

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