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Recent Advances in the Management of Vascular Calcification in Patients with End-Stage Renal Disease

Kosaku Nitta1, Tetsuya Ogawa2, Norio Hanafusa3

  • 1Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan, knitta@kc.twmu.ac.jp.

Contributions to Nephrology
|April 17, 2019
PubMed

Insights

Vascular calcification (VC) in chronic kidney disease (CKD) patients is complex. Understanding treatments for VC, including novel therapies like magnesium and vitamin K, may improve outcomes for CKD patients on dialysis.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Vascular calcification (VC) is prevalent in chronic kidney disease (CKD), including end-stage renal disease (ESRD).
  • VC contributes to arterial stiffening and cardiovascular mortality.
  • CKD patients face traditional and non-traditional risk factors for VC.

Purpose of the Study:

  • To review current treatment strategies and targets for managing VC in ESRD patients.
  • To highlight the role of novel therapies such as magnesium and vitamin K supplementation.
  • To emphasize the potential of improved VC management in reducing mortality rates.

Main Methods:

  • Literature review of current therapeutic approaches for CKD-mineral bone disorder.
  • Summary of conventional treatments: dietary phosphate restriction, phosphate binders, active vitamin D, and calcimimetics.
  • Discussion of emerging therapies and their investigation in clinical trials.

Main Results:

  • Conventional treatments for CKD-mineral bone disorder may inhibit VC progression but face challenges in achieving biochemical targets.
  • Current strategies focus on managing calcium, phosphate, parathyroid hormone, and vitamin D levels.
  • Fetuin-A's role in inhibiting VC by binding to calciprotein particles is highlighted.

Conclusions:

  • Improved understanding and management of VC in CKD patients, particularly those on dialysis, could enhance survival rates.
  • Novel therapeutic avenues, including magnesium and vitamin K, show promise.
  • Fetuin-A represents a key factor in preventing mineral accretion in VC.
Abstract

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