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Arterial accelerated aging in dialysis patients: the clinical impact of vascular calcification

Diego Brancaccio1, Antonio Bellasi, Mario Cozzolino

  • 1Department of Nephrology, San Paolo Hospital, University of Milan, Italy. diego.brancaccio@ tiscalinet.it

Current Vascular Pharmacology
|July 16, 2009
PubMed

Insights

Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) involves abnormal bone and mineral metabolism, leading to vascular calcification (VC) and increased mortality. Current strategies focus on managing calcium, phosphate, and parathyroid hormone levels to prevent VC progression.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pathology

Background:

  • Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) is a complex condition affecting mineral and bone metabolism in CKD patients.
  • CKD-MBD is characterized by serum calcium and phosphate imbalances, altered bone turnover, and vascular calcification (VC).
  • VC in uremic patients shares similarities with bone mineralization, suggesting a biological link to mineral derangements and increased mortality.

Purpose of the Study:

  • To review the current understanding of vascular calcification (VC) in Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD).
  • To summarize evidence-based strategies for preventing and treating VC in CKD patients.
  • To highlight the link between VC and increased mortality in CKD-MBD.

Main Methods:

  • Review of current literature on CKD-MBD and vascular calcification.
  • Analysis of the biological processes underlying VC in CKD.
  • Synthesis of evidence supporting current treatment modalities for VC.

Main Results:

  • Vascular calcification begins in early CKD stages and is prevalent in advanced stages (CKD-3, -4, -5).
  • The presence and extent of VC are associated with poor prognosis in CKD patients.
  • VC is an active biological process analogous to bone mineralization.

Conclusions:

  • Effective management of calcium, phosphate, and parathyroid hormone is crucial in CKD-MBD.
  • Utilizing calcium-free phosphate binders and vitamin D analogs are key therapeutic strategies.
  • These interventions aim to improve quality of life and reduce mortality in CKD patients by mitigating VC.

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