Imaging has contributed to the successful reduction of cardiovascular morbidity and mortality in the general population and it has demonstrated excellent potential among patients with chronic kidney disease (CKD). The well-known severity of cardiovascular disease in patients suffering from CKD requires an accurate risk stratification of these patients in several clinical situations. Alterations of both structure and function of the myocardium as well as severe vasculopathy are highly prevalent in patients with advanced CKD. Hence sophisticated imaging techniques are at times necessary to make an accurate assessment of risk. Two main forms of arterial pathology develop in patients with CKD: atherosclerosis, with accumulation of inflammatory cells, lipids, fibrous tissue and calcium in the sub-intimal space of the artery, and arteriosclerosis. The latter is characterized by thickening and calcification of the muscular layer of the arterial wall and it is not necessarily associated with typical atherosclerotic changes. This review explores the indications, strengths and weaknesses of several invasive and non-invasive imaging modalities employed to evaluate myocardial and vascular disease in CKD.
Keywords: arteriosclerosis; atherosclerosis; coronary artery disease; myocardial disease; myocardial fibrosis; vascular calcifications.
Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.