scholarly journals The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 772
Author(s):  
Ana Pimentel ◽  
Jordi Bover ◽  
Grahame Elder ◽  
Martine Cohen-Solal ◽  
Pablo Antonio Ureña-Torres
Keyword(s):  
Computed Tomography ◽  
Chronic Kidney Disease ◽  
Magnetic Resonance ◽  
Kidney Disease ◽  
Imaging Techniques ◽  
Quantitative Computed Tomography ◽  
Vertebral Fracture Assessment ◽  
Vascular Calcifications ◽  
Ckd Stage

Although frequently silent, mineral and bone disease (MBD) is one of the most precocious complication of chronic kidney disease (CKD) and is omnipresent in patients with CKD stage 5. Its pathophysiology is complex, but basically, disturbances in vitamin D, phosphate, and calcium metabolism lead to a diverse range of clinical manifestations with secondary hyperparathyroidism usually being the most frequent. With the decline in renal function, CKD-MBD may induce microstructural changes in bone, vascular system and soft tissues, which results in macrostructural lesions, such as low bone mineral density (BMD) resulting in skeletal fractures, vascular and soft tissue calcifications. Moreover, low BMD, fractures, and vascular calcifications are linked with increased risk of cardiovascular mortality and all-cause mortality. Therefore, a better characterization of CKD-MBD patterns, beyond biochemical markers, is helpful to adapt therapies and monitor strategies as used in the general population. An in-depth characterization of bone health is required, which includes an evaluation of cortical and trabecular bone structure and density and the degree of bone remodeling through bone biomarkers. Standard radiological imaging is generally used for the diagnosis of fracture or pseudo-fractures, vascular calcifications and other features of CKD-MBD. However, bone fractures can also be diagnosed using computed tomography (CT) scan, magnetic resonance (MR) imaging and vertebral fracture assessment (VFA). Fracture risk can be predicted by bone densitometry using dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QTC) and peripheral quantitative computed tomography (pQTC), quantitative ultrasound (QUS) and most recently magnetic resonance micro-imaging. Quantitative methods to assess bone consistency and strength complete the study and adjust the clinical management when integrated with clinical factors. The aim of this review is to provide a brief and comprehensive update of imaging techniques available for the diagnosis, prevention, treatment and monitoring of CKD-MBD.

Evaluation of the level of natriuretic peptides in the diagnosis and characterization of chronic kidney disease and cardiorenal syndrome in children

2021 ◽  
Vol 25 (6) ◽  
pp. 87-92
Author(s):  
A. M. Mambetova ◽  
D. V. Bizheva ◽  
I. K. Thabisimova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Natriuretic Peptides ◽  
Cardiorenal Syndrome ◽  
Stage I ◽  
Group Iii ◽  
Early Stages ◽  
Group I ◽  
Ckd Stage

BACKGROUND. Natriuretic peptides have cardio- and renoprotective effects, inhibiting inflammatory and proliferative processes. The role of natriuretic peptides in the early diagnosis and characterization of chronic kidney disease (CKD) and cardiovascular complications as the disease development and progresses has not been studied.TNEAIM: to study the level of natriuretic peptides in children depending on the stage of CKD development and to assess the significance of this indicator.PATIENTS AND METHODS. The study involved 93 children with congenital diseases of the urinary system at the age from 3 to 18 years. Three groups were identified: group I - 54 patients with CKD stage I , group II - 29 patients with CKD stage II; Group III - 10 children with CKD stages IV-V (patients with CKD stages IV and V were combined due to their small amount). Control group - 10 clinically healthy children of the corresponding age. The N-terminal propeptide of natriuretic hormone (NT-proBNP) was determined in the blood by the enzyme-linked immunosorbent assay.RESULTS. An increase in the level of NT-proBNP by 28.7% takes place already in the early stages of CKD. With the progression of CKD, an increase in the level of NT-proBNP was noted from 57.4 % in children in the group of patients with stage I CKD to 80 % in children in group III patients. The maximum concentrations of NT-proBNP, many times higher than those in CKD stages I and II, were observed in children with CKD stages IV-V. The degree of increase in the level of NT-proBNP correlated with the severity of CKD.CONCLUSION. In the diagnosis and characterization of CKD and cardiorenal syndrome in children, the determination of the level of natriuretic peptides is of great importance. A high level of natriuretic peptides characterizes the presence of cardiorenal relationships and can be used as an additional criterion for assessing the severity of CKD, including at the early stages of its development.

P1241CALCIFICATIONS IN DIFFERENT VASCULAR BEDS ACROSS THE SPECTRUM OF CHRONIC KIDNEY DISEASE INCLUDING CALCIFIC UREMIC ARTERIOLOPATHY: ARE SKIN PUNCH BIOPSIES USEFUL?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anne Kristine Roendbjerg ◽  
Marianne Rix ◽  
Mette Gyldenløve ◽  
Dorrit Krustrup ◽  
Ilse Vejborg ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Dialysis Patients ◽  
Vascular Calcifications ◽  
Ckd Stage ◽  
Calcific Uremic Arteriolopathy ◽  
Skin Biopsies ◽  
Vascular Beds ◽  
Unaffected Skin

Abstract Background and Aims Accelerated vascular calcification in different vascular beds is common in patients with chronic kidney disease (CKD). A severe form of vascular calcifications is calcific uremic arteriolopathy (CUA) presenting with painful ischemic skin lesions and high mortality. The prognostic value of skin biopsies in relation to CUA is unclear and the prevalence of skin vascular calcifications in different stages of CKD is sparsely described. The aim of the study was to describe the occurence of small vesssel vascular calcifications in unaffected skin biopsies in relation to calcifications in other vascular beds across the spectrum of CKD including CUA. Method A cross-sectional cohort (total, n=39) comprising dialysis patients with current or previous CUA (CKD5D+CUA, n=9), dialysis patients without CUA (CKD5D-CUA, n=12), patients with CKD stage 3-4 (CKD3-4, n=12), and healthy kidney controls (control, n=6). The presence of vascular calcifications in the dermis and subcutis were assessed in 4 mm punch biopsies of unaffected skin from the lateral thigh. The presence of vascular calcification was evaluated by H&E, von Kossa and Alizarin staining. The presence of breast arterial calcifications (BAC) was evaluated by mammography, the abdominal aortic calcification score (AAC) by lateral lumbar X-ray and calcification propensity was measured by T50 reflecting the calcification propensity in blood. Results None of the included patients showed vascular calcifications in skin biopsies. Declining kidney function was associated with presence of BAC, increased AAC and reduced T50 (Table). No significant difference was found between CKD5D+CUA and CKD5D-CUA regarding BAC (p=1.000), AAC (p=0.815) or T50 (p=0.165). CKD5D+CUA compared to all other groups had no difference in BAC (p=0.109) and AAC (p=0.141) but reduced T50 (p=0.004). Dialysis patients (CKD5D±CUA) had significant more BAC (p=0.003), higher AAC (p<0.001) and lower T50 (p<0.001). Conclusion No vascular calcifications were found in punch biopsies from unaffected skin in patients with different stages of CKD including CUA. Despite imaging verified vessel calcification by BAC and AAC and increased calcification propensity by T50. This suggest that conventional punch biopsies cannot be used to identify skin vascular calcification and thereby patients at risk for developing CUA.

scholarly journals SAT-181 CHARACTERIZATION OF ADVANCED LIPOPROTEIN PARAMETERS BY NUCLEAR MAGNETIC RESONANCE IN NON-DIABETIC CHRONIC KIDNEY DISEASE PATIENTS

2019 ◽  
Vol 4 (7) ◽  
pp. S83-S84
Author(s):  
G. CORTÁZAR ◽  
T. BRETONES DEL PINO ◽  
M. Bermudez-Lopez ◽  
J.J. Bretones Alcaraz ◽  
E. Fernandez ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Nuclear Magnetic Resonance ◽  
Magnetic Resonance ◽  
Kidney Disease ◽  
Nuclear Magnetic

Trends in Nanotechnology for in vivo Cancer Diagnosis: Products and Patents

2020 ◽  
Vol 26 (18) ◽  
pp. 2167-2181
Author(s):  
Tatielle do Nascimento ◽  
Melanie Tavares ◽  
Mariana S.S.B. Monteiro ◽  
Ralph Santos-Oliveira ◽  
Adriane R. Todeschini ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Quantum Dots ◽  
Magnetic Resonance ◽  
Metal Nanoparticles ◽  
Cancer Diagnosis ◽  
Imaging Techniques ◽  
Tumor Detection ◽  
Abnormal Growth ◽  
Pharmaceutical Nanotechnology

Background: Cancer is a set of diseases formed by abnormal growth of cells leading to the formation of the tumor. The diagnosis can be made through symptoms’ evaluation or imaging tests, however, the techniques are limited and the tumor detection may be late. Thus, pharmaceutical nanotechnology has emerged to optimize the cancer diagnosis through nanostructured contrast agent’s development. Objective: This review aims to identify commercialized nanomedicines and patents for cancer diagnosis. Methods: The databases used for scientific articles research were Pubmed, Science Direct, Scielo and Lilacs. Research on companies’ websites and articles for the recognition of commercial nanomedicines was performed. The Derwent tool was applied for patent research. Results: This article aimed to research on nanosystems based on nanoparticles, dendrimers, liposomes, composites and quantum dots, associated to imaging techniques. Commercialized products based on metal and composite nanoparticles, associated with magnetic resonance and computed tomography, have been observed. The research conducted through Derwent tool displayed a small number of patents using nanotechnology for cancer diagnosis. Among these patents, the most significant number was related to the use of systems based on metal nanoparticles, composites and quantum dots. Conclusion: Although few systems are found in the market and patented, nanotechnology appears as a promising field for the development of new nanosystems in order to optimize and accelerate the cancer diagnosis.

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