The Key Role of Phosphate on Vascular Calcification

Mario Cozzolino1, Paola Ciceri2, Andrea Galassi3

  • 1Renal Division, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy. mario.cozzolino@unimi.it.

Toxins
|April 12, 2019
PubMed

Insights

Vascular calcification is a hallmark of chronic kidney disease (CKD), increasing cardiovascular disease risk. Managing calcium and phosphate balance is crucial, as specific therapies to reverse vascular calcification are lacking.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Vascular Biology

Background:

  • Vascular calcification (VC) is prevalent in chronic kidney disease (CKD) patients, irrespective of dialysis status.
  • VC is considered a hallmark of CKD and is linked to cardiovascular disease (CVD) and mortality.
  • VC manifests in various forms, each indicating systemic vascular disease and higher CVD prevalence in CKD.

Purpose of the Study:

  • To review the significance of vascular calcification in CKD.
  • To identify major risk factors contributing to VC in CKD patients.
  • To discuss current management strategies and the lack of specific therapies for VC.

Main Methods:

  • Literature review of clinical studies on vascular calcification in CKD.
  • Analysis of risk factors associated with VC progression.
  • Evaluation of the impact of phosphate binders on VC.

Main Results:

  • Key risk factors for VC in CKD include advanced age, long dialysis vintage, hyperphosphatemia, hypercalcemia, and positive calcium/phosphate balance.
  • Excessive oral calcium intake and calcium-based phosphate binders exacerbate VC.
  • Non-calcium-based phosphate binders are associated with reduced VC progression.

Conclusions:

  • VC is a significant complication in CKD, associated with increased CVD risk.
  • Management should focus on balancing calcium and phosphate levels.
  • Effective therapies to prevent or reverse VC in CKD are currently unavailable.

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