Arterial calcification and pathology in uremic patients undergoing dialysis

Ibels, L. S.; Alfrey, Allen C.; Huffer, William E.; Craswell, Peter W.; Anderson, James T.; Weil, Richard

doi:10.1016/0002-9343(79)91118-5

Cited by 303 publications

(180 citation statements)

References 25 publications

Supporting

Mentioning

169

Contrasting

Unclassified

Order By: Relevance

“…21,22 Hypertrophy of connective tissue with an increased collagen-toelastin ratio are characteristic arterial wall changes in aging leading to impaired arterial distensibility. 9,22 In uremic patients the collagen-to-elastin ratio of the arterial wall is increased 23 suggesting that pre-existing irreversible changes of the arterial wall are also common in patients shortly after renal transplantation. Nevertheless, hypertension exerted further adverse effects on arterial distensibility in renal transplant recipients despite pre-existing irreversible structural vessel wall modifications.…”

Section: Discussionmentioning

confidence: 99%

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

et al. 1998

View full text Add to dashboard Cite

The mechanisms responsible for reduced arterial distensibility in renal transplant recipients remain to be evaluated. The present longitudinal study was aimed to evaluate the effect of hypertension on the evolution of vessel wall properties in renal transplant recipients. The mechanical properties of the common carotid artery were determined in 24 normotensive and 24 treated hypertensive renal transplant recipients 6-12 weeks after transplantation. The measurements were repeated after 2 years. Arterial distension was determined by using a multigate pulsed Doppler system, blood pressure (BP) was measured by a mercury sphygmomanometer. BP was 127 ؎ 3/80 ؎ 2 mm Hg at entry and 133 ؎ 3/82 ؎ 2 mm Hg after 2 years in the normotensive group, 146 ؎ 4/90 ؎ 3 mm Hg at entry and 145 ؎ 3/87 ؎ 2 mm Hg after 2 years in the hypertensive group (P Ͻ 0.01, normotensives vs hypertensives). The distens-

show abstract

Section: Discussionmentioning

confidence: 99%

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

et al. 1998

View full text Add to dashboard Cite

show abstract

“…The best known cardiovascular consequence of hyperphosphatemia is vascular calcification, which is a common complication of ESRD and diabetes (15)(16)(17). Vascular calcification, at the cellular level, is an active process that can be induced by hyperphosphatemia (14).…”

Section: Physiologic Consequences Of Hyperphosphatemiamentioning

confidence: 99%

Left Ventricular Hypertrophy

Achinger

Ayus

2006

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Cardiovascular disease occurs in ESRD patients at rates that are far higher than is seen in the general population, and cardiovascular deaths account for the majority of deaths among dialysis patients. Abnormal mineral metabolism is a novel cardiovascular risk factor among dialysis patients. Recently published results demonstrated that even with good control of BP and anemia, conventional hemodialysis is associated with significant left ventricular hypertrophy (LVH); however, daily hemodialysis was associated with a significant reduction in LV mass index (LVMI). Furthermore, it was shown that control of serum phosphorus correlates with the reduction in LVMI. These data suggest a novel mechanism for the deleterious effect of elevated serum phosphorus on cardiovascular outcomes among hemodialysis patients: LVH. Other investigators have noted an association of hyperphosphatemia and LVH; however, this study was the first to demonstrate that improvement in serum phosphorus is associated with reduction in LVM. In addition, it is shown that daily hemodialysis is an effective modality in improving serum phosphorus through significantly improved phosphorus removal. Elevated serum phosphorus leads to vascular calcification, which can lead to LVH by decreasing vascular compliance. However, our study showed an improvement in LVMI during a 12-mo period. Because vascular calcification is unlikely to remit over this time period, it is proposed that serum phosphorus has a reversible, cardiotoxic effect that leads to LVH that can be reversed successfully with good control of serum phosphorus.

show abstract

“…The average age of the group of patients who died of cardiovascular causes (49 years) was higher than that of the groups who died of other causes, except for the two patients who died of malignant neoplasms ( Table 2). As new pharmacologic methods of managing plasma lipid disorders become available, it may become possible to prevent or even reverse the arterial pathologic conditions 29 and hyperlipidemia 15 that are so destructive to some of these patients. Early coronary artery bypass may also increase longevity for some patients, 30 although the indications for this procedure are still controversial.…”

Section: Cardiovascular Deathsmentioning

confidence: 99%

Causes of Death After Kidney Transplantation

Washer¹

1983

JAMA

View full text Add to dashboard Cite

Durtng the five-year period September 1074 through August '1979"two to the many physicians outside transhundred nine consecutive patients rec,lved their first kidney transplant In plant ~nterswho are now caring for Denver. During 2.5 to 7.5' years of foDow-up. 54 paUents (28%) died. kidney transplant patients. Infection was the leading cause of death during .. Interval. and was METHODS re.ponslble for 22 (41%) of the 54 deaths. Pneumonia was prtmarUy We, have reviewed the results of 209 re.ponslble for 14 of the 22 deaths from Infection. The other cau.e. of death CODSeCUtive patients who received their were cardiovascular problems In11 patient. (20%), suicide In eight paUents first kidney transplant at the University (15%). gastrOintestinal (GI) tract problems In .. ven paUents (13%), mangnsnt of Colorado Health Sciences Center and neopla.ms In two patient. (4%), and miscellaneous probIems-ln-four-paUentsthe Dcm¥R VeterlUlLAdminiatntioQ Hoe----' ,-'(7%). Twenty-alx ,(48%) of the 54 deaths occurred more than one year after pital during the fi.,.-year period Septemprtmary'transplantatlon; 12 of these 28 patlenla had already returned to ber 19"l4 throush August 1979. By meaDS of inpatient chart review, outpatient chart chronic hemodialysis. To minimize mortality atter transplantation, patients review, and telephone calldo patients and and their physician. must remain alert to the ongoing rt.ks to which the.. ,families, follow-up information for all paUent. are exposed, Including the rI.ks of sudden death from Infection.patients has been updated to Feb 1. U82. myocardial Infarction, pulmonary embolu., SUicide, or GI tract perforation. ~ range .or,foU cnr -Il P for the.155 lllniv-(JAifA 1983;250:4~54) • .. " ' / . 0 . patients ia 2.5 to 1.5, JUI'I (mean, 58 . ,. . months). Patients• _ho received a lint _ . ~ -' '~Diney transplaDt before •September 19'14

show abstract

Arterial calcification and pathology in uremic patients undergoing dialysis

Cited by 303 publications

References 25 publications

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

Left Ventricular Hypertrophy

Causes of Death After Kidney Transplantation

Contact Info

Product

Resources

About