scholarly journals Vascular calcification and plasma levels of osteopontin in patients with chronic kidney disease who are treated by program hemodyalisis

2014 ◽  
Vol 0 (3) ◽  
Author(s):  
V. A. Vizir ◽  
A. V. Abramov ◽  
A. S. Sadomov ◽  
E. G. Ovska

Background: The incidence of heart death is 5-10 times more in patients with chronic kidney disease (CKD) with regular hemodialysis compared to the general population. Vascular calcification is a risk factor. In CKD patients there is a decrease in the distal renal cell cells which are the main producer of Klotho in the body. The functions of Klotho are maintaining integrity, endothelial permeability and endogenous inhibitors of vascular calcification. Previous studies reported an association between vascular calcification and Klotho plasma levels. Vascular calcification for heart disease can be determined by the thickness Intima Media (TIM) Carotid Artery. Objective: To determine the correlation of plasma Klotho levels with the Intima Media thickness of the Carotid Artery in CKD patients with regular hemodialysis. Methode: This cross-sectional study was conducted at the Rasyida Kidney General Hospital in Medan from April to July 2018. Patients with CKD who have undergone routine hemodialysis are examined for plasma levels of Klotho and real time ultrasound examinations to determine the thickness of arterial intima media carotid. Data are analyzed with Mann Whitney test, binominal logistic regression and Pearson correlation. Results: Seventy patients with CKD showed an average plasma Klotho level of 281.43 + 298.63 pg / ml with an average TIM of the carotid artery of 0.22 + 0.09 cm. Patients were divided into 2 groups, namely the calcification group (n = 39) and the noncalcified group (n = 31). Mann-Whitney test was performed with the results that there were differences in plasma Klotho levels between the calcification group and the noncalcified carotid artery group which were statistically significant (p = 0.001). The binominal logistic regression analysis test was performed on risk factors associated with the incidence of vascular calcification and the results of Klotho serum levels, Diabetes Mellitus and Hypertension were found to be significant risk factors for calcification (p <0.05). With the Pearson correlation test, the negative correlation of plasma Klotho levels with the thickening of Intima Carotid Arterial Media was statistically significant with moderate correlation strength (p = 0.002; r = -0.368). Conclusion: Patients with chronic kidney disease with low plasma Klotho levels have thickening of the intima media of carotid artery.


2020 ◽  
Author(s):  
Maria L Mace ◽  
Eva Gravesen ◽  
Anders Nordholm ◽  
Soeren Egstrand ◽  
Marya Morevati ◽  
...  

Author(s):  
Adhi Permana ◽  
Ian Effendi ◽  
Taufik Indrajaya

Chronic kidney disease is associated with a high mortality rate, especially cardiovascular disease associated with mineral and bone disorders. Sclerostin is an inhibitor of Wnt signaling which has the effect of increasing the occurrence of vascular calcification in patients with chronic kidney disease. There are several studies that show different results. Carotid intima media thickness ultrasound examination is a tool to identify atherosclerosis which is part of vascular calcification. The aim of this study is to look at the correlation of sclerostin with carotid intima media thickness (CIMT) in patients with chronic kidney disease undergoing hemodialysis. In this cross section, the concentration of sclerostin was measured by examination of enzymed linked immunosorbent assay. CIMT measurement by ultrasound mode B examination. There were 40 patients in this study. The mean sclerostin level was 256.68 ± 127.76 pg / ml. Sclerostin levels are declared high if above 162 pg / ml there are 30 people. CIMT thickening was present in 11 patients. There was no significant correlation of serum sclerostin with CIMT in patients with chronic kidney disease undergoing hemodialysis (r-0.32 p0,847). In multivariate linear regression, hemodialysis duration is an independent factor that is significantly significant with CIMT. There was no significant correlation of serum sclerostin with CIMT in patients with chronic kidney disease undergoing hemodialysis.


2019 ◽  
Vol 20 (4) ◽  
pp. 421-430
Author(s):  
Zar Chi Thent ◽  
Gabriele R.A. Froemming ◽  
Suhaila Abd Muid

Increasing interest in vascular pseudo-ossification has alarmed the modern atherosclerotic society. High phosphate is one of the key factors in vascular pseudo ossification, also known as vascular calcification. The active process of deposition of the phosphate crystals in vascular tissues results in arterial stiffness. High phosphate condition is mainly observed in chronic kidney disease patients. However, prolonged exposure with high phosphate enriched foods such as canned drinks, dietary foods, etc. can be considered as modifiable risk factors for vascular complication in a population regardless of chronic kidney disease. High intake of vitamin K regulates the vascular calcification by exerting its anti-calcification effect. The changes in serum phosphate and vitamin K levels in a normal individual with high phosphate intake are not well investigated. This review summarised the underlying mechanisms of high phosphate induced vascular pseudo ossification such as vascular transdifferentiation, vascular apoptosis and phosphate uptake by sodium-dependent co-transporters. Pubmed, Science Direct, Scopus, ISI Web of Knowledge and Google Scholar were searched using the terms ‘vitamin K’, ‘vascular calcification, ‘phosphate’, ‘transdifferentiation’ and ‘vascular pseudoossification’. Vitamin K certainly activates the matrix GIA protein and inhibits vascular transition and apoptosis in vascular pseudo-ossification. The present view highlighted the possible therapeutic linkage between vitamin K and the disease. Understanding the role of vitamin K will be considered as potent prophylaxis agent against the vascular disease in near future.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anique D. ter Braake ◽  
◽  
Larissa P. Govers ◽  
Mieke J. Peeters ◽  
Arjan D. van Zuilen ◽  
...  

Abstract Background Higher plasma magnesium concentrations are associated with reduced cardiovascular disease risk in chronic kidney disease (CKD) patients. The importance of plasma magnesium concentration for vascular calcification in earlier stages of CKD remains underexplored. This study investigated whether plasma magnesium is a determinant for the presence and severity of vascular calcification in moderate CKD. Methods Retrospective analysis was performed using abdominal aortic calcification (AAC) scores in 280 patients with stage 3 and 4 CKD enrolled in the MASTERPLAN trial. Lateral abdominal X-ray was used to evaluate AAC. Plasma magnesium concentration were measured over time. A zero-inflated Poisson model determined the association between plasma magnesium concentration and AAC. Results 79 out of 280 patients did not have AAC, and in patients with AAC the median calcification score was 3.5 (interquartile range: 0.0–8.6). The mean plasma magnesium concentration was 0.76 ± 0.10 mmol/L at baseline. A 0.1 mmol/L higher plasma magnesium concentration was associated with lower AAC of 0.07 point (95% CI -0.28 – 0.14). A 0.1 mmol/L higher plasma magnesium lowered the odds of detecting any AAC by 30% (OR = 0.63; 95% CI 0.29–1.37). After 1 year and 4 years (at time of X-ray) of follow-up this association was attenuated (OR = 0.93; 95% CI 0.61–1.43 and 0.93; 95% CI 0.60–1.45, respectively). None of these associations reached statistical significance. Conclusions Plasma magnesium concentration at baseline is not associated with the risk for future AAC. Interventions increasing magnesium to avoid vascular calcification may have greatest potential in early CKD stages prior to onset of vascular calcification.


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