Kivonat:
Chronic kidney disease (CKD) is a major factor contributing to
cardiovascular (CV) morbidity and mortality with the highest
risk in patients on dialysis. An estimation of CV risk is
important not only to identify potential modifiable risk factors
but also to evaluate the effect of treatments aimed to reduce
the risk. Non-invasive methods of measuring vascular changes and
circulating biomarkers are available to assess the presence and
severity of cardiovascular damage. These include measures of
structural (carotid intima-media thickness and coronary artery
calcification score) and functional (aortic pulse wave velocity,
24-h ambulatory blood pressure monitoring, ambulatory arterial
stiffness index, heart rate variability and flow-mediated
dilatation) changes in the vessel wall. In addition, a number of
circulating biomarkers of vascular damage and its progression
have been studied. Many of these tests are well validated as
surrogate markers of future cardiovascular events and death in
adult CKD patients, but need technical adaptation,
standardization and validation for use in children. With our
current state of knowledge, these are best reserved for research
studies and scarce clinical resources may be better utilized for
preventative strategies to reduce the modifiable risk factors
for calcification from early CKD stages.