Vascular calcification and renal osteodystrophy relationship in chronic kidney disease

Research output: Contribution to journalArticle

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Abstract

Cardiovascular disease and stroke account for 60-70% of all deaths in patients with end-stage renal disease (ESRD), at a risk that is 10-20-fold the age- and sex-matched general population. There is also increased coronary artery calcification and increased cardiovascular mortality in chronic kidney disease (CKD) and dialysis patients compared with the general population. Bone is similarly abnormal in CKD. There is an increased incidence of low bone mass and fractures in dialysis patients compared with the general population. Furthermore, a hip fracture in a dialysis patient is associated with a doubling of the mortality observed in nondialysis patients with a hip fracture. These two problems may be linked, as cross-sectional studies have demonstrated an inverse relationship between osteoporosis and coronary artery calcification in the general population and in ESRD patients. In vitro and ex vivo, there is clear evidence that vascular calcification is an active cell-mediated process, made worse by disorders of mineral metabolism. Many factors known to be associated with cardiovascular disease in CKD patients can directly increase calcification in vitro. In addition, in CKD, there are many mechanisms by which bone may adversely affect vascular calcification including disorders of bone remodelling, altered secretion of parathyroid hormone (PTH), hyperphosphatemia, hypercalcaemia, use of calcium based binders, and excessive vitamin D therapy. The coexistence of vascular risk factors and abnormal bone represent a double threat to the well being of patients with CKD.

Original languageEnglish
Pages (from-to)51-62
Number of pages12
JournalEuropean Journal of Clinical Investigation
Volume36
Issue numberSUPPL. 2
DOIs
StatePublished - Aug 2006

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Chronic Kidney Disease-Mineral and Bone Disorder
Vascular Calcification
Chronic Renal Insufficiency
Bone
Dialysis
Hip Fractures
Bone and Bones
Population
Chronic Kidney Failure
Coronary Vessels
Cardiovascular Diseases
Hyperphosphatemia
Mortality
Bone Remodeling
Bone Fractures
Hypercalcemia
Parathyroid Hormone
Vitamin D
Osteoporosis
Minerals

Keywords

  • CKD
  • ESRD
  • Osteoporosis
  • Renal osteodystrophy
  • Vascular calcification

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Vascular calcification and renal osteodystrophy relationship in chronic kidney disease. / Moe, Sharon.

In: European Journal of Clinical Investigation, Vol. 36, No. SUPPL. 2, 08.2006, p. 51-62.

Research output: Contribution to journalArticle

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