Premature coronary artery disease and early stage chronic kidney disease.

Abstract

A 30 year old asymptomatic male with stage 3 chronic kidney disease (CKD) secondary to Focal Segmental Glomerulosclerosis was found to have features of CKD associated cardiomyopathy including left ventricular hypertrophy (LVH) and focal sub-endocardial scarring on cardiac magnetic resonance imaging. There was also a significantly raised CT coronary calcium score and evidence of non-flow limiting coronary artery disease (CAD) on a CT coronary angiogram. Early stage CKD is a major risk factor for cardiovascular risk causing myocardial hypertrophy and fibrosis and coronary artery atheroma. Cardiovascular risk begins to increase from an eGFR of around 75ml/min/1.73m2. The pathophysiology of cardiovascular disease in CKD is under investigation but to date, treatment options are limited. Blood pressure control and statins have the strongest supportive evidence.

• Authors: A M Price, C J Ferro, M K Hayer, R P Steeds, N C Edwards, J N Townend
• Journal: QJM : monthly journal of the Association of Physicians (QJM) Vol. 111 Issue 10 Pg. 683-686 (Oct 01 2018) ISSN: 1460-2393 [Electronic] England
• PMID: 29024966 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Adult
• Coronary Angiography (adverse effects)
• Coronary Artery Disease (diagnostic imaging, etiology)
• Fibrosis
• Glomerular Filtration Rate
• Humans
• Magnetic Resonance Imaging
• Male
• Renal Insufficiency, Chronic (complications, pathology)
• Risk Factors