Effects of excess calcium load on the cardiovascular system measured with electron beam tomography in end‐stage renal disease

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Abstract
Cardiovascular disease is the leading cause of morbidity and mortality in dialysis patients and current research indicates that it might be linked to high serum phosphorus levels and calcium–phosphorus product. The severe osteopathy known to exist in end‐stage renal disease (ESRD) patients is often coupled with an inability of bone to handle excess calcium loads. This might predispose to overflow and deposition of calcium and phosphate crystals in various soft tissues and in particular the cardiovascular apparatus. Atherosclerosis is a slow process that expands in the context of the arterial intimal layer and it is for the most part associated with extracellular calcification. Electron beam tomography (EBT) is a radiological technique utilized to non‐invasively visualize this silent marker of atherosclerosis: vascular calcification. Several investigations conducted in non‐ESRD patients have conclusively demonstrated that coronary calcification indicates a high risk for cardiac events. As EBT allows precise estimates of the extent of vascular and valvular calcification, it might become an important clinical tool in ESRD patients to assess the effect of excess calcium and phosphate load in soft tissues, estimate the cardiovascular risk of events and gauge the effectiveness of therapy.