Abstract
Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) is a systemic disorder of mineral and bone metabolism that occurs in Chronic Kidney Disease (CKD). In addition to abnormalities in serum calcium (Ca) and phosphate (P) profile, CKD-MBD is characterized by abnormalities of bone turnover, mineralization, volume and growth as well as vascular calcification (VC). Indeed, the co-localization of bone markers such as Osteopontin, Alkaline Phosphatase and Osteocalcin along with osteoblast-like cells in the contest of the arterial wall of uremic patients, indicate that VC is an active biological process with peculiar analogies with bone mineralization. Thus, VC represents a plausible link between Ca and P derangements and the increased mortality associated with CKD-MBD. The process of VC starts in early stages of CKD and patients with CKD-3, -4 and -5 not undergoing haemodialysis may present a significant burden of calcification in the coronaries. Considering that presence and extent of VC in CKD portend poor prognosis, many efforts have been made to shed light on this complicated phenomenon to prevent VC deposition and progression. Indeed, careful control of calcium load, serum P and parathyroid hormone along with the use of calcium-free P binders and vitamin D analogs represent our current armamentarium to improve quality of life and reduce mortality in CKD. We herein summarize the current understanding and evidence supporting strategies available for VC treatment.
Keywords: Vascular calcification, mortality, mineral metabolism abnormalities, treatment
Current Vascular Pharmacology
Title: Arterial Accelerated Aging in Dialysis Patients: The Clinical Impact of Vascular Calcification
Volume: 7 Issue: 3
Author(s): Diego Brancaccio, Antonio Bellasi, Mario Cozzolino, Andrea Galassi and Maurizio Gallieni
Affiliation:
Keywords: Vascular calcification, mortality, mineral metabolism abnormalities, treatment
Abstract: Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) is a systemic disorder of mineral and bone metabolism that occurs in Chronic Kidney Disease (CKD). In addition to abnormalities in serum calcium (Ca) and phosphate (P) profile, CKD-MBD is characterized by abnormalities of bone turnover, mineralization, volume and growth as well as vascular calcification (VC). Indeed, the co-localization of bone markers such as Osteopontin, Alkaline Phosphatase and Osteocalcin along with osteoblast-like cells in the contest of the arterial wall of uremic patients, indicate that VC is an active biological process with peculiar analogies with bone mineralization. Thus, VC represents a plausible link between Ca and P derangements and the increased mortality associated with CKD-MBD. The process of VC starts in early stages of CKD and patients with CKD-3, -4 and -5 not undergoing haemodialysis may present a significant burden of calcification in the coronaries. Considering that presence and extent of VC in CKD portend poor prognosis, many efforts have been made to shed light on this complicated phenomenon to prevent VC deposition and progression. Indeed, careful control of calcium load, serum P and parathyroid hormone along with the use of calcium-free P binders and vitamin D analogs represent our current armamentarium to improve quality of life and reduce mortality in CKD. We herein summarize the current understanding and evidence supporting strategies available for VC treatment.
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Brancaccio Diego, Bellasi Antonio, Cozzolino Mario, Galassi Andrea and Gallieni Maurizio, Arterial Accelerated Aging in Dialysis Patients: The Clinical Impact of Vascular Calcification, Current Vascular Pharmacology 2009; 7 (3) . https://dx.doi.org/10.2174/157016109788340730
DOI https://dx.doi.org/10.2174/157016109788340730 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
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