Vascular calcification in chronic kidney disease

Goodman, William G.; London, Gérard M.; Amann, Kerstin; Block, Geoffrey A.; Giachelli, Cecilia M.; Hruska, Keith A.; Ketteler, Markus; Levin, Adeera; Massy, Ziad A.; McCarron, David A.; Raggi, Paolo; Shanahan, Catherine M.; Yorioka, Noriaki

doi:10.1053/j.ajkd.2003.12.005

Cited by 358 publications

(263 citation statements)

References 63 publications

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“…Several explanations for the relationship of FGF23 to CKD progression are suggested. First, FGF23 levels might reflect phosphate exposure in the general population with normal renal function (32,33), which is also likely in CKD patients although very limited data are available in CKD. Therefore, our finding is reasonable because phosphate load, per se, deteriorates renal function (34,35).…”

Section: Discussionmentioning

confidence: 99%

Combined Use of Vitamin D Status and FGF23 for Risk Stratification of Renal Outcome

Nakano

Hamano

Fujii

et al. 2012

Clinical Journal of the American Society of Nephrology

115

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SummaryBackground and objectives Hyperphosphatemia, vitamin D deficiency, hyperparathyroidism, and high serum fibroblast growth factor 23 (FGF23) levels, when studied separately, were found to predict the progression of CKD. However, studies with simultaneous measurement of mineral bone disorder (MBD)-related factors were scarce. This study aimed to identify factors predicting renal outcome independent of other factors.Design, setting, participants, & measurements This was a prospective cohort study of 738 Japanese predialysis outpatients in the nephrology departments of two hospitals. The outcome was defined as a doubling of serum creatinine or initiation of dialysis.Results Mean estimated GFR (eGFR) was 35 ml/min per 1.73 m 2 . At enrollment, the increase in intact FGF23 with decreasing eGFR was the earliest among changes in MBD-related factors, followed by 1,25-dihydroxyvitamin D decrease, parathyroid hormone increase, and phosphate increase. Conclusions Combined use of two markers is useful for the risk stratification of renal outcome.

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Section: Discussionmentioning

confidence: 99%

Combined Use of Vitamin D Status and FGF23 for Risk Stratification of Renal Outcome

Nakano

Hamano

Fujii

et al. 2012

Clinical Journal of the American Society of Nephrology

115

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“…Существуют два типа кальцификации КА: интимальная и медиальная (табл. 1) [18]. При отсутствии типичных ФР атероскле-роза кальцификация медии (медиакальциноз, склероз Менкеберга) чаще наблюдается у молодых пациентов на диализе.…”

Section: хбп и коронарный атероск лерозunclassified

Prognostic Importance of Chronic Kidney Disease in Patients With Acute Coronary Syndrome

Alidzhanova¹,

Rzhevskaya²,

Sagirov³

et al. 2017

Neotložnaâ med. pomoŝʹ

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ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы», Москва, Российская Федерация * Контактная информация: Алиджанова Хафиза Гафуровна, доктор медицинских наук, старший научный сотрудник отделения неотложной клинической кардиологии с методами неинвазивной функциональной диагностики НИИ скорой помощи им.Н.В.Склифосовского. Е-mail: doctorhafiza@mail.ru РЕЗЮМЕ Изучение острого коронарного синдрома (ОКС) у больных хронической болезнью почек (ХБП) является одним из направлений современной кардиологии. Распространенность, течение, про-гноз и тактика лечения инфаркта миокарда при ХБП недостаточно изучены. Анализ литературных источников позволяет констатировать: ХБП при ОКС удваивает риск смерти (РС) и неблагоприят-ных сердечно-сосудистых событий в ближайшем и отдаленном периодах; определение стадии ХБП необходимо с целью прогнозирования госпитальной и отдаленной смертности инфарктных больных; диагностика ОКС на поздних стадиях ХБП сложна; ХБП следует считать независимым РС после проведения чрескожных коронарных вмешательств и коронарного шунтирования. Ключевые слова:хроническая болезнь почек, скорость клубочковой фильтрации, атеросклероз коронарных арте-рий, острый коронарный синдром, реваскуляризация миокарда

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“…This medial or Monckeberg sclerosis increases vascular stiffness and reduces compliance, which in turn lead to left ventricular hypertrophy and compromised coronary blood flow during diastole. 3 Arterial calcification in adults with chronic kidney disease is associated with adverse clinical outcome including myocardial infarction, congestive heart failure, endocarditis, valvular heart disease, peripheral vascular disease, and death. 5,6 Calciphylaxis, later termed calcific uremic arteriolopathy, is a skin disorder characterized by arteriolar calcification in the dermis leading to painful red nodules or plaques often with livedo reticularis that progress to ulcerative lesions.…”

Section: Discussionmentioning

confidence: 99%

“…1 Although arterial calcification has been recognized for many years as a complication of CKD, the mechanisms responsible are not well understood, but abnormalities in mineral metabolism in general and disturbances in phosphorus metabolism in particular traditionally have been considered important determinants. 3 ESRD patients carry a number of risk factors for vascular calcification including atherosclerosis, diabetes, hypertension, and abnormalities in calcium phosphorus metabolism. 4 Vascular calcification is currently considered an actively regulated process.…”

Section: Discussionmentioning

confidence: 99%

Severe extraossous calcification in chronic kidney disease

Prabahar

Sivakumar

Rajendran

et al. 2006

Dialysis & Transplantation

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Background. The most frequent cause of death in patients with chronic kidney disease (CKD) is a cardiovascular event. Disturbances of mineral and bone metabolism result in vascular calcification, which partly accounts for the increased cardiovascular morbidity and mortality. Extraosseous calcification in CKD can produce a range of pathologies including calcific uremic arteriolopathy, extraosseous soft-tissue calcification, calcification involving solid organs, and corneal, conjunctival, peritoneal, vascular, and valvular calcification. In rare instances, calcification can involve all of these structures. Patient. We report a CKD patient with extensive extraosseous calcification and calciphylaxis. A 45-year-old woman, known to have CKD since 2001, presented to us with painful ulcers in both great toes and exertional dyspnea. Results. Investigations revealed severe renal failure, anemia, hypoalbuminemia, hyperphosphatemia, and normal corrected calcium. Her imaging studies showed diffuse uniform calcification of femoral, posterior tibial, radial, ulnar, and digital arteries. Ophthalmological consultation obtained for red eye suggested this condition was a result of conjunctival and corneal calcification. In a plain abdominal x-ray she had visceral calcification, subcutaneous calcification, and calcification of her abdominal arteries. A Doppler study of both upper-and lower-limb arteries was normal. Biopsy from the skin adjacent to the ulcer was suggestive of calciphylaxis. A superficial temporal artery biopsy showed medial calcification and subintimal fibrosis. Her iPTH was 5,560 pg/mL, and ultrasound of the neck revealed diffusely enlarged parathyroid glands. Alcohol ablation was attempted but failed. The patient was treated with daily dialysis, aluminum-based phosphate binder, and aggressive wound care, and a parathyroidectomy was planned. The patient had sudden cardiac death on dialysis.Conclusions. This case is presented to highlight all components of extraosseous calcification in a single patient including soft-tissue, visceral, and vascular calcification, and calciphylaxis.

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Vascular calcification in chronic kidney disease

Cited by 358 publications

References 63 publications

Combined Use of Vitamin D Status and FGF23 for Risk Stratification of Renal Outcome

Combined Use of Vitamin D Status and FGF23 for Risk Stratification of Renal Outcome

Prognostic Importance of Chronic Kidney Disease in Patients With Acute Coronary Syndrome

Severe extraossous calcification in chronic kidney disease

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