Clin Osteol 2008; 13(4): 166-171

Vascular involvement in chronic kidney disease - mineral and bone disorderReview articles

J. Zahálková

Cardiovascular (CV) involvement regularly develops in impaired calcium and phosphorus metabolism due to a common pathophy­ siological basis of bone and vascular changes. The predominant manifestation is increased formation of ectopic CV calcifications. The­ ir extent significantly increases CV morbidity and is closely correlated with patient mortality. The vascular system and other soft tissues become an alternative reservoir for calcium and phosphate storage in a situation when, due to impaired remodelling, the ske­ leton is unable to compensate for changes in the overall mineral balance. Vascular smooth muscle cells, actively participating in the calcification process, undergo osteochondral transformation, express osteogenic proteins and form a mineralized matrix, based on the size of the current deficit of systemic and local inhibitors of calcification. The anatomical and vascular localization of mineral depo­ sits determines the type of arteriopathy (arteriosclerosis and atherosclerosis) and the resulting clinical picture. The multifunctional cha­ racter of some anti-calcification proteins (such as fetuin A also formed as a negative acute phase reactant) inflammation in formation of calcifications and atherosclerosis.

Keywords: mineral and bone disorder, chronic kidney disease, vascular smooth muscle cell osteochondral trans­ formation and mineralization, calcification inhibitors, chronic inflammation, atherosclerosis

Published: December 11, 2008  Show citation

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Zahálková J. Vascular involvement in chronic kidney disease - mineral and bone disorder. Osteologický bulletin. 2008;13(4):166-171.
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