Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) [1]. As a consequence, patients with CKD are considered at high risk and as coronary heart disease equivalent [2]. Different diagnostic algorithms are used in normal clinical practice to predict global cardiovascular risk; however, in CKD the utility of these tests is limited due to uremia-specific risk factors. As a result, it is necessary to explore CKD-specific diagnostic tools to help predict cardiovascular risk in patients with CKD.In this issue of Cardiology, Fink et al. [3] describe a novel method of assessing preclinical myocardial metabolic alterations as a marker of CVD in pre-dialysis patients with CKD. They employed quantitative F18-fluo-rodeoxyglucose positron emission tomography (FDG PET) as a means to measure myocardial glucose utilization (MGU) in 13 non-diabetic patients.
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