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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
The bone-vascular axis in chronic kidney disease
1Department of Medicine, University of California, Los Angeles, California 90095-1679, USA. Ldemer@mednet.ucla.edu
Current Opinion in Nephrology and Hypertension
|May 29, 2010
Summary
Chronic kidney disease is linked to bone and vascular calcification, impacting renal, skeletal, and vascular systems. Understanding these connections is crucial for comprehensive patient care.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Endocrinology
Background:
- Chronic kidney disease (CKD) significantly impacts mineral and bone metabolism.
- CKD affects renal, skeletal, and vascular tissues, a condition termed CKD-mineral bone disorder (CKD-MBD).
- The interplay between these tissues is increasingly recognized in systems physiology.
Purpose of the Study:
- To review recent literature on the relationship between bone and vascular calcification in CKD patients.
- To highlight emerging understanding of CKD-MBD mechanisms.
Main Methods:
- Literature review of recent publications.
- Analysis of biochemical factors involved in CKD-MBD.
- Examination of treatment effects on interconnected tissues.
Main Results:
- Identified key biochemical factors: phosphatonins (fibroblast growth factor-23), bone morphogenetic protein 7, osteoprotegerin, matrix GLA protein, ectonucleotide pyrophosphatase/phosphodiesterase 1, alkaline phosphatase, and lipid oxidation products.
- Demonstrated that treatments for one component of CKD-MBD can affect others, both positively and negatively.
- Highlighted the systemic nature of CKD-MBD, involving renal, skeletal, and vascular systems.
Conclusions:
- Consistent synchrony exists among CKD, aortic calcification, and bone loss.
- These findings suggest underlying mechanisms for systemic abnormalities in CKD.
- Emphasized the need to avoid single-organ viewpoints in managing CKD-MBD.
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