Pathogenesis and Management of Vascular Calcification in Patients with End-Stage Renal Disease

2018 ◽  
pp. 71-77 ◽  
Author(s):  
Tetsuya Ogawa ◽  
Kosaku Nitta
Keyword(s):  
Renal Disease ◽  
Vascular Calcification ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

P0791MATRIX GLA PROTEIN AND PREMATURE VASCULAR CALCIFICATION IN PATIENTS WITH END-STAGE RENAL DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Lu Dai ◽  
Abdul Rashid Tony Qureshi ◽  
Jonaz Ripsweden ◽  
Torkel B Brismar ◽  
Magnus Söderberg ◽  
...  
Keyword(s):  
Renal Disease ◽  
Vascular Calcification ◽  
Vitamin K ◽  
End Stage Renal Disease ◽  
Protective Factor ◽  
Matrix Gla Protein ◽  
Vascular Aging ◽  
Dialysis Vintage ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Vitamin K is a potential protective factor against premature vascular aging and vascular calcification (VC). Whether vitamin K supplement could halt VC progression in patients with end-stage renal disease (ESRD) is not clear, partially due to the heterogeneity of measurements of VC in different vascular sites. Here we investigated the associations between non-phosphorylated, uncarboxylated matrix-Gla protein (dp-ucMGP), a circulating marker of vitamin K insufficiency, and premature vascular aging phenotypes evaluated by coronary artery calcium (CAC) scoring, aortic valve calcium (AVC) scoring, and histology scoring of presence of media calcification in vascular biopsies in patients with ESRD. Method In this observational cohort study, 223 ESRD patients (median age 54 years, 68% males) comprising non-dialysis patients (n=109), prevalent peritoneal dialysis (PD, n=80, median dialysis vintage 11.6 months) and prevalent hemodialysis patients (HD, n=34, median dialysis vintage 12.0 months) underwent baseline measurements of plasma dp-ucMGP and scoring of CAC and AVC by computed tomography scan. Framingham risk score (FRS), inflammation and other relevant clinical and biochemical data were determined at baseline. In a sub-group of patients (n=94), scoring of media calcification by histology in epigastric artery biopsies was also performed. Results Plasma dp-ucMGP levels (median 1568 pmol/L) significantly correlated with age (rho=0.38), presence of cardiovascular disease (CVD, rho=0.16), triglycerides (rho=0.19), FRS (rho=0.33), high-sensitivity C-reactive protein (hsCRP; rho=0.35), CAC score (rho=0.30) and AVC score (rho=0.24) but did not differ with regards to treatment modality (i.e. non-dialysis, PD and HD). In multivariate regression analyses, with adjustment for presence of CVD, FRS, hsCRP and triglycerides, increased dp-ucMGP levels were independently associated with increased CAC score (coefficients 0.12, p=0.04), but not with AVC score nor presence of media calcification in epigastric arteries. Conclusion Our data suggest that vitamin K insufficiency as indicated by increased dp-ucMGP levels associates with premature vascular calcification evaluated by CAC but not with AVC or media calcification assessed by histology. This discrepancy warrants further studies to explore the pathophysiological background between vitamin K metabolism and susceptibility of calcification in different vascular sites as well as the pattern of VC (i.e. intima and media calcification) within sites.

scholarly journals Sex-specific relationship between vascular calcification and incident fracture in patients with end-stage renal disease

2020 ◽  
Vol 39 (3) ◽  
pp. 344-355
Author(s):  
Yun Jung Nam ◽  
So Yeon Hwang ◽  
Da Won Kim ◽  
Dongryul Kim ◽  
Seok Joon Shin ◽  
...  
Keyword(s):  
Renal Disease ◽  
Vascular Calcification ◽  
End Stage Renal Disease ◽  
Specific Relationship ◽  
Incident Fracture ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Bone mineral density and mortality in end-stage renal disease patients

2020 ◽  
Vol 13 (3) ◽  
pp. 307-321 ◽  
Author(s):  
Ken Iseri ◽  
Lu Dai ◽  
Zhimin Chen ◽  
Abdul Rashid Qureshi ◽  
Torkel B Brismar ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Renal Disease ◽  
Cortical Bone ◽  
Vascular Calcification ◽  
Bone Mineral ◽  
End Stage Renal Disease ◽  
Mineral Density ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Osteoporosis characterized by low bone mineral density (BMD) as assessed by dual-energy X-ray absorptiometry (DXA) is common among end-stage renal disease (ESRD) patients and associates with high fracture incidence and high all-cause mortality. This is because chronic kidney disease-mineral bone disorders (CKD-MBDs) promote not only bone disease (osteoporosis and renal dystrophy) but also vascular calcification and cardiovascular disease. The disturbed bone metabolism in ESRD leads to ‘loss of cortical bone’ with increased cortical porosity and thinning of cortical bone rather than to loss of trabecular bone. Low BMD, especially at cortical-rich bone sites, is closely linked to CKD-MBD, vascular calcification and poor cardiovascular outcomes. These effects appear to be largely mediated by shared mechanistic pathways via the ‘bone–vascular axis’ through which impaired bone status associates with changes in the vascular wall. Thus, bone is more than just the scaffolding that holds the body together and protects organs from external forces but is—in addition to its physical supportive function—also an active endocrine organ that interacts with the vasculature by paracrine and endocrine factors through pathways including Wnt signalling, osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/RANK ligand system and the Galectin-3/receptor of advanced glycation end products axis. The insight that osteogenesis and vascular calcification share many similarities—and the knowledge that vascular calcification is a cell-mediated active rather than a passive mineralization process—suggest that low BMD and vascular calcification (‘vascular ossification’) to a large extent represent two sides of the same coin. Here, we briefly review changes of BMD in ESRD as observed using different DXA methods (central and whole-body DXA) at different bone sites for BMD measurements, and summarize recent knowledge regarding the relationships between ‘low BMD’ and ‘fracture incidence, vascular calcification and increased mortality’ in ESRD patients, as well as potential ‘molecular mechanisms’ underlying these associations.

Association of serum phosphate with valvular and vascular calcification in patients with end-stage renal disease

2020 ◽  
Vol 5 (3) ◽  
pp. 262
Author(s):  
Abolhasan Haseib ◽  
Abdalla Kelani ◽  
AhmedA Obiedellah ◽  
MostafaA Nashwa ◽  
EssamM Abdel Aziz ◽  
...  
Keyword(s):  
Renal Disease ◽  
Vascular Calcification ◽  
End Stage Renal Disease ◽  
Serum Phosphate ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Vascular calcification in end-stage renal disease

2013 ◽  
Vol 17 ◽  
pp. S17-S21 ◽  
Author(s):  
Kristen L. Jablonski ◽  
Michel Chonchol
Keyword(s):  
Renal Disease ◽  
Vascular Calcification ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Histopathologic Review of Calcemic Uremic Arteriolopathy: A Case Series

2019 ◽  
Vol 53 (2) ◽  
Author(s):  
Jay-V James G. Barit ◽  
Eileen Liesl A. Cubillan
Keyword(s):  
Renal Disease ◽  
Vascular Calcification ◽  
End Stage Renal Disease ◽  
Subcutaneous Fat ◽  
Case Series ◽  
Chronic Dialysis ◽  
Fat Necrosis ◽  
Proper Diagnosis ◽  
Stage Renal Disease ◽  
End Stage

Calcemic uremic arteriolopathy or calciphylaxis is an uncommon disorder presenting clinically as skin ischemia and necrosis, and histologically as vascular calcification and thrombosis of dermal and subdermal vasculature. This study described two Filipino females with end-stage renal disease on chronic dialysis with non-healing ulcers on the lower extremities as a result of calcification in the vessels of the dermis and subcutaneous fat with associated fat necrosis. Current understanding of its various histologic features was reviewed for proper diagnosis.

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