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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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The Kidney-Vascular-Bone Axis in the Chronic Kidney Disease-Mineral Bone Disorder

Michael E Seifert1, Keith A Hruska

  • 11 Division of Pediatric Nephrology, Department of Pediatrics, Southern Illinois University, Springfield, IL. 2 Division of Pediatric Nephrology, Department of Pediatrics, Washington University, St. Louis, MO.

Transplantation
|September 11, 2015
PubMed

Insights

Chronic kidney disease-mineral bone disorder (CKD-MBD) impacts kidney transplant patients, contributing to cardiovascular disease and graft injury. Understanding CKD-MBD

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Kidney transplantation survival has improved, but long-term outcomes are limited by cardiovascular disease and chronic allograft injury.
  • Cardiovascular disease is a major cause of mortality in patients with native chronic kidney disease (CKD).
  • CKD-MBD is a complex syndrome involving biochemical, skeletal, and cardiovascular changes in kidney disease.

Purpose of the Study:

  • To review the pathophysiology of CKD-MBD.
  • To explore emerging concepts of pathogenic factors linking injured kidneys to cardiovascular disease.
  • To discuss implications for chronic allograft injury and vasculopathy.

Main Methods:

  • Literature review of current knowledge on CKD-MBD pathophysiology.
  • Analysis of emerging concepts regarding pathogenic factors in CKD-MBD.
  • Discussion of potential applications to kidney transplant outcomes.

Main Results:

  • CKD-MBD encompasses novel cardiovascular risk factors beyond traditional renal osteodystrophy.
  • Pathogenic factors released from injured kidneys directly contribute to cardiovascular disease in CKD.
  • These factors may play a role in chronic allograft injury and vasculopathy.

Conclusions:

  • CKD-MBD is a critical syndrome impacting both native and transplant kidney disease patients.
  • Understanding CKD-MBD pathophysiology is essential for improving cardiovascular and allograft survival.
  • Targeting pathogenic factors may offer new therapeutic strategies.

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