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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Update on Chronic Kidney Disease Mineral and Bone Disorder in Cardiovascular Disease

Joseph Lunyera1, Julia J Scialla2

  • 1Department of Medicine, Duke University School of Medicine, Durham, NC.

Seminars in Nephrology
|November 11, 2018
PubMed

Insights

Chronic kidney disease mineral and bone disorder (MBD) is linked to cardiovascular disease. Precision medicine approaches may offer new therapeutic strategies for MBD, improving patient outcomes.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Chronic kidney disease mineral and bone disorder (MBD) involves widespread metabolic changes in kidney disease.
  • MBD components are frequently associated with cardiovascular disease (CVD) in epidemiological studies.
  • MBD may directly contribute to CVD through various mechanisms including hypertension and vascular calcification.

Purpose of the Study:

  • To review the complex interactions within MBD and their link to CVD.
  • To explore the challenges in MBD assessment and treatment.
  • To discuss the potential of precision medicine in managing MBD and its cardiovascular complications.

Main Methods:

  • Review of conventional and precision epidemiology in MBD.
  • Analysis of potential mechanisms linking MBD to cardiovascular disease pathogenesis.
  • Discussion of therapeutic principles for established and emerging treatments.

Main Results:

  • MBD components, including mineral ions, vitamin D, FGF23, and PTH, exhibit complex biological interactions.
  • These interactions present challenges for clinical trials and treatment translation.
  • Precision medicine, genomics, and individualized risk assessment show promise for advancing MBD management.

Conclusions:

  • MBD is a significant factor in cardiovascular disease associated with chronic kidney disease.
  • The intricate nature of MBD necessitates advanced approaches like precision medicine.
  • Further research and individualized therapies are crucial for effective MBD and CVD management in kidney disease patients.

Keywords:
Cardiovascular diseasefibroblast growth factor 23klothomineral metabolismphosphorusvitamin D

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