Arterial Calcification in Chronic Kidney Disease: Key Roles for Calcium and Phosphate

Shanahan, Catherine M.; Crouthamel, Matthew H.; Kapustin, Alexander; Giachelli, Cecilia M.

doi:10.1161/circresaha.110.234914

Cited by 794 publications

(754 citation statements)

References 165 publications

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“…[23][24][25] These modifications occur progressively during CKD evolution and lead to an increased stiffness, which, as shown in this study, impacts detrimentally on the outcome of patients with CKD. Indeed, increased aortic PWV influences the timing of reflected waves return.…”

Section: Discussionsupporting

confidence: 56%

Large Artery Stiffening and Remodeling Are Independently Associated With All-Cause Mortality and Cardiovascular Events in Chronic Kidney Disease

et al. 2012

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Chronic kidney disease, even at moderate stages, is characterized by a high incidence of cardiovascular events. Subclinical damage to large arteries, such as increased arterial stiffness and outward remodeling, is a classical hallmark of patients with chronic kidney disease. Whether large artery stiffness and remodeling influence the occurrence of cardiovascular events and the mortality of patients with chronic kidney disease (stages 2–5) is still debated. This prospective study included 439 patients with chronic kidney disease (mean age, 59.8±14.5 years) with a mean measured glomerular filtration rate of 37 mL/min per 1.73 m 2 . Baseline aortic stiffness was estimated through carotid-femoral pulse wave velocity measurements; carotid stiffness, diameter, and intima-media thickness were measured with a high-resolution echotracking system. For the overall group of patients, the 5-year estimated survival and cumulative incidence of cardiovascular events were 87% and 16%, respectively. In regression analyses adjusted on classical cardiovascular and renal risk factors, aortic stiffness remained significantly associated with all-cause mortality (for 1 SD, Cox model–derived relative risk [95% CI], 1.48 [1.09–2.02]) and with fatal and nonfatal cardiovascular events (for 1 SD, Fine and Gray competing risks model–derived relative risk [95% CI], 1.35 [1.05–1.75]). Net reclassification improvement index was significant (29.0% [2.3–42.0%]). Carotid internal diameter was also independently associated with all-cause mortality. This study shows that increased aortic stiffness and carotid internal diameter are independent predictors of mortality in patients with stages 2 to 5 chronic kidney disease and that aortic stiffness improves the prediction of the risk.

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Section: Discussionsupporting

confidence: 56%

Large Artery Stiffening and Remodeling Are Independently Associated With All-Cause Mortality and Cardiovascular Events in Chronic Kidney Disease

et al. 2012

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“…In rodents, warfarin treatment induces rapid VC and decreased arterial compliance (5,6) akin to elastocalcinosis, a condition prevalent in the elderly population and characterized by calcium deposition along the elastic lamellae. Extensive research over the past decades has established that VC is at least in part a cell-mediated process that includes stimulation of osteogenic/chondrogenic differentiation in vascular smooth muscle (7,8), vesicle release, apoptosis, extracellular matrix degradation, and loss of calcification inhibitors (9,10).…”

Section: Vascular Calcification (Vc)mentioning

confidence: 99%

Quercetin Attenuates Warfarin-induced Vascular Calcification in Vitro Independently from Matrix Gla Protein

Beazley

Eghtesad

Nurminskaya

2013

Journal of Biological Chemistry

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Background: Molecular mechanism(s) of warfarin-induced vascular calcification are not well known. Results: Inhibition of ␤-catenin signaling with shRNA or quercetin prevents osteoblastic transformation and calcification in VSMCs and calcification in aortic rings treated with warfarin, independent from MGP and protein carboxylation. Conclusion: Quercetin inhibits vascular calcification via ␤-catenin signaling. Significance: Quercetin may be instrumental in treatment of warfarin-induced vascular calcification.

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“…Arterial Calcification in Chronic Kidney Disease: Key Roles for Calcium and Phosphate (Review); Shanahan et al 28 …”

Section: Resultsmentioning

confidence: 99%

Circulation Research Thematic Synopsis

2012

Circulation Research

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Circulation Research Thematic Synopses:The goal of Thematic Synopses is to provide our readers with a concise but comprehensive overview of the work published in Circulation Research, which we hope will keep our readers abreast of recent scientific discoveries and facilitate discussion, interpretation, and integration of the findings. These collections of articles are organized thematically and are listed in chronological order, beginning with the most recent ones. In each synopsis, the top downloaded original research articles (normalized to time since publication) are highlighted in yellow. Review articles also are included, with titles highlighted in blue, and the summary of each is provided. Instead of using abstracts, we have elected to publish the Novelty and Significance section of each article, which we believe provides a clear précis of the salient findings and their implications in a language that is easily understandable by the noninitiated. This will enable readers who are not experts in a particular field to grasp the significance and impact of work performed in other fields. It is our hope and expectation that Thematic Synopses will help readers to gain a broader awareness and a deeper understanding of the status of research across the vast landscape of cardiovascular research. -The Editors Circulation Research Thematic Synopsis AtherosclerosisThe Editors D espite an approximately 40% reduction in mortality during the past 30 years, cardiovascular diseases remain the number one cause of death in the United States (http://www.cdc.gov/nchs/fastats/heart.htm) and globally (http://www.who.int/mediacenter/factsheets/fs317/en/index.html) (both accessed on July 15, 2012). The threat is unabated, because cardiovascular diseases, with atherosclerosis and its thrombotic complications leading the way, are projected to remain the single leading cause of death in the world in the next 20 years (http://www.who.int/mediacenter/factsheets/ fs317/en/index.html). Justifiably, it is not surprising that the molecular pathogenesis of atherosclerosis and acute thrombotic syndromes continues to remain the subject of intense research. In conjunction with the intense laboratory research and in view of the enormous burden of cardiovascular diseases, which claim approximately 800 000 lives per year in the United States alone, 1 the United States Department of Health and Human Services along with the American Heart Association and other organizations has launched the "Million Hearts" initiatives aimed at preventing 1 million myocardial infarctions (MIs) and strokes over the next 5 years (http://www.cdc.gov/24 -7/prevention/MillionHearts/ accessed July 15, 2012).Despite the intense research and heightened interest, delineation of the complete spectrum of etiologies in atherosclerosis has remained largely elusive. Perhaps the most direct and robust evidence for the causal factors in atherosclerosis originated from the genetic studies of rare Mendelian diseases, such as familial hypercholesterolemia and Tangier disease. The disc...

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Arterial Calcification in Chronic Kidney Disease: Key Roles for Calcium and Phosphate

Cited by 794 publications

References 165 publications

Large Artery Stiffening and Remodeling Are Independently Associated With All-Cause Mortality and Cardiovascular Events in Chronic Kidney Disease

Large Artery Stiffening and Remodeling Are Independently Associated With All-Cause Mortality and Cardiovascular Events in Chronic Kidney Disease

Quercetin Attenuates Warfarin-induced Vascular Calcification in Vitro Independently from Matrix Gla Protein

Circulation Research Thematic Synopsis

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