Blood Purif 2002;20:494–497
(DOI:10.1159/000065203)

Advanced Oxidation Protein Products, Parathyroid Hormone and Vascular Calcification in Uremia

Drüeke T.B. · Massy Z.A.
Inserm U507 et Service de Néphrologie, Hôpital Necker, Paris, France
email Corresponding Author


 goto top of outline Key Words

  • Vascular calcification
  • Uremia
  • Oxidative stress
  • Advanced oxidation protein products
  • Parathyroid hormone

 goto top of outline Abstract

Vascular calcification is a frequent complication of uremic patients. In addition to classical risk factors such as age, male gender, smoking, inflammation, hypertension, dyslipidemia, and diabetes, which also exist in the general population, patients with chronic renal failure have other risk factors such as oxidative stress, inflammation, hyperparathyroidism, hypoparathyroidism, hypercalcemia, hyperphosphatemia, and overtreatment with calcium and vitamin D. These latter risk factors may even have a better predictive value than classical risk factors for coronary heart disease in uremic patients.

Copyright © 2002 S. Karger AG, Basel


 goto top of outline References
  1. Drueke TB, Touam M, Thornley-Brown D, Rostand SG: Extraskeletal calcification in patients with chronic kidney failure. Adv Nephrol Necker Hosp 2000;30:333–356.

    External Resources

  2. Milliner DS, Zinsmeister AR, Lieberman E, Landing B: Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int 1990;38:931–936.
  3. Cheung AK, Sarnak MJ, Yan G, et al: Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients. Kidney Int 2000;58:353–362.

    External Resources

  4. London GM, Drueke TB: Atherosclerosis and arteriosclerosis in chronic renal failure. Kidney Int 1997;51:1678–1695.
  5. Schwarz U, Buzello M, Ritz E, et al: Morphology of coronary atherosclerotic lesions in patients with end-stage renal failure. Nephrol Dial Transplant 2000;15:218–223.
  6. Burke AP, Kolodgie FD, Farb A, Weber D, Virmani R: Morphological predictors of arterial remodeling in coronary atherosclerosis. Circulation 2002;105:297–303.
  7. Guerin AP, London GM, Marchais SJ, Metivier F: Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrol Dial Transplant 2000;15:1014–1021.

    External Resources

  8. Handelman GJ, Walter MF, Adhikarla R, et al: Elevated plasma F2-isoprostanes in patients on long-term hemodialysis. Kidney Int 2001;59:1960–1966.
  9. Holvoet P, Donck J, Landeloos M, et al: Correlation between oxidized low density lipoproteins and von Willebrand factor in chronic renal failure. Thromb Haemost 1996;76:663–669.
  10. Satoh M, Yamasaki Y, Nagake Y, et al: Oxidative stress is reduced by the long-term use of vitamin E-coated dialysis filters. Kidney Int 2001;59:1943–1950.

    External Resources

  11. Tarng DC, Huang TP, Wei YH, et al: 8-Hydroxy-2′-deoxyguanosine of leukocyte DNA as a marker of oxidative stress in chronic hemodialysis patients. Am J Kidney Dis 2000;36:934–944.
  12. Witko-Sarsat V, Friedlander M, Capeillère-Blandin C, et al: Advanced oxidation protein products as a novel marker of oxidative stress in uremia. Kidney Int 1996;49:1304–1313.
  13. Malle E, Woenckhaus C, Waeg G, Esterbauer H, Grone EF, Grone HJ: Immunological evidence for hypochlorite-modified proteins in human kidney. Am J Pathol 1997;150:603–615.
  14. Sakata N, Imanaga Y, Meng J, et al: Increased advanced glycation end products in atherosclerotic lesions of patients with end-stage renal disease. Atherosclerosis 1999;142:67–77.
  15. Kaneda H, Taguchi J, Ogasawara K, Aizawa T, Ohno M: Increased level of advanced oxidation protein products in patients with coronary artery disease. Atherosclerosis 2002;162:221–225.

    External Resources

  16. Witko-Sarsat V, Friedlander M, Nguyen Khoa T, et al: Advanced oxidation protein products as novel mediators of inflammation and monocyte activation in chronic renal failure. J Immunol 1998;161:2524–2532.
  17. Miyata T, Wada Y, Cai Z, et al: Implication of an increased oxidative stress in the formation of advanced glycation end products in patients with end-stage renal failure. Kidney Int 1997;51:1170–1181.
  18. Nguyen-Khoa T, Massy ZA, Witko-Sarsat V, et al: Oxidized low-density lipoprotein induces macrophage respiratory burst via its protein moiety: A novel pathway in atherogenesis? Biochem Biophys Res Commun 1999;263:804–809.
  19. Bergt C, Reicher H, Malle E, Sattler W: Hypochlorite modification of high density lipoprotein: Effects on cholesterol efflux from J774 macrophages. FEBS Lett 1999;452:295–300.
  20. Drueke TB, Witko-Sarsat V, Massy Z, et al.: Iron therapy, advanced oxidation protein products and carotid artery intima-media thickness in end-stage renal disease. Circulation 2002, in press.
  21. Goodman WG, Goldin J, Kuizon BD, et al: Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000;342:1478–1483.
  22. Raggi P, Boulay A, Chasan-Taber S, et al: Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease? J Am Coll Cardiol 2002;39:695–701.
  23. Urena P, Malergue MC, Goldfarb B, Prieur P, Guedon-Rapoud C, Petrover M: Evolutive aortic stenosis in hemodialysis patients: Analysis of risk factors. Nephrologie 1999;20:217–225.
  24. Rostand SG, Drueke TB: Parathyroid hormone, vitamin D, and cardiovascular disease in chronic renal failure. Kidney Int 1999;56:383–392.
  25. Drueke TB: Medical management of secondary hyperparathyroidism in uremia. Am J Med Sci 1999;317:383–389.
  26. Jono S, McKee MD, Murry CE, et al: Phosphate regulation of vascular smooth muscle cell calcification. Circ Res 2000;87:E10–E17.
  27. Tintut Y, Patel J, Territo M, Saini T, Parhami F, Demer LL: Monocyte/macrophage regulation of vascular calcification in vitro. Circulation 2002;105:650–655.
  28. Luo G, Ducy P, McKee MD, et al: Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA protein. Nature 1997;386:78–81.
  29. Bucay N, Sarosi I, Dunstan CR, et al: Osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification. Genes Dev 1998;12:1260–1268.
  30. Jahnen-Dechent W, Schafer C, Heiss A, Grotzinger J: Systemic inhibition of spontaneous calcification by the serum protein alpha 2-HS glycoprotein/fetuin. Z Kardiol 2001;90:47–56.

    External Resources


 goto top of outline Author Contacts

Tilman B. Drüeke, MD
Inserm U507 et Service de Néphrologie
Hôpital Necker, 161, rue de Sèvres
F–75743 Paris Cedex 15 (France)
Tel. +33 1 44 49 52 33, Fax +33 1 45 66 51 33, E-Mail drueke@necker.fr


 goto top of outline Article Information

Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 0, Number of References : 30


 goto top of outline Publication Details

Blood Purification (Official Journal of the International Society of Blood Purification (ISBP))
Founded 1983; edited by K. Schaefer (1983–1988)
Official Journal of the International Society of Blood Purification

Vol. 20, No. 5, Year 2002 (Cover Date: 2002)

Journal Editor: L.W. Henderson, McGaw Park, Ill.
ISSN: 0253–5068 (print), 1421–9735 (Online)

For additional information: http://www.karger.com/journals/bpu


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