Blood Purification

Focus: Calcium and Phosphate Control in CKD. Guest Editor: P. Messa, Milan

Impact of Disturbances of Calcium and Phosphate Metabolism on Vascular Calcification and Clinical Outcomes in Patients with Chronic Kidney Disease

Nikolov I.G.a, b · Mozar A.a · Drüeke T.B.b · Massy Z.A.a

Author affiliations

aInserm ERI-12, University of Picardie and Amiens University Hospital, Amiens, and bInserm Unit 845, Necker Medical School, University Paris-Descartes, Paris, France

Keywords: Chronic kidney diseaseCalciumPhosphorusVascular calcificationUremic toxins

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Blood Purif 2009;27:350–359
https://doi.org/10.1159/000209248

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Article / Publication Details

First-Page Preview
Abstract of Focus: Calcium and Phosphate Control in CKD. Guest Editor: P. Messa, Milan

Published online: March 18, 2009
Issue release date: May 2009

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 0

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Chronic kidney disease (CKD) is frequently complicated by arterial calcification. The latter is part of the associated mineral and bone disorder (CKD-MBD). Hypercalcemia and hyperphosphatemia have long been known to play a major role in the occurrence of vascular and other soft tissue calcification in patients with CKD, together with endocrine disturbances including vitamin D, parathyroid hormone, fibroblast growth factor-23, and klotho. In addition, many other systemic and local promoters, including inflammation and uremic toxins, contribute to the occurrence of vascular calcification, despite a powerful defense system made up of systemic and local inhibitors, as demonstrated in elegant experimental studies done in vitro and in vivo. Most importantly, several reports have shown that both hyperphosphatemia and hypophosphatemia, and to a lesser degree hypercalcemia and hypocalcemia, are associated with an increased relative risk of mortality in patients with CKD. However, all these reports were observational in nature and must therefore be considered as hypothesis generating. It remains to be demonstrated in prospective randomized trials whether normalization of serum phosphorus and/or calcium leads to better patient outcome. In order to improve outcome in patients with CKD-MBD, early medical intervention is of utmost importance.

© 2009 S. Karger AG, Basel



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Article / Publication Details

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Abstract of Focus: Calcium and Phosphate Control in CKD. Guest Editor: P. Messa, Milan

Published online: March 18, 2009
Issue release date: May 2009

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 0

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

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2009, Vol.27, No. 4

May 2009

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