Bone and mineral disorders in chronic kidney disease: implications for cardiovascular health and ageing in the general population
Por:
Covic A., Vervloet M., Massy Z.A., Torres P.U., Goldsmith D., Brandenburg V., Mazzaferro S., Evenepoel P., Bover J., Apetrii M., Cozzolino M.
Publicada:
1 ene 2018
Resumen:
The patient with chronic kidney disease (CKD) represents an extreme model for arteriosclerosis, vascular calcification, and bone disorders, all of which are also associated with ageing in the general population. These pathological features are also relevant to other common chronic health disorders such as diabetes, and chronic inflammatory and cardiovascular diseases. Although management and interventions for these major risk factors are now incorporated into most public health guidelines (eg, smoking cessation and control of bodyweight and blood pressure, as well as glucose and cholesterol concentrations), some residual cardiovascular risk is not reduced by implementation of these interventions. CKD should be regarded as an atypical disease in which both traditional and novel cardiovascular risk factors have effects on outcomes. But CKD can also be viewed conceptually as an accelerator of traditional cardiovascular risk factors. Findings from research into mineral bone disorder associated with CKD (CKD–MBD) could help the medical community to better understand the vascular actions of certain molecules, such as phosphates, fibroblast growth factor 23, parathyroid hormone, sclerostin, or vitamin D and their relevance to the management of different pathologies in the general population. Importantly, these components, which are recognised in nephrology, could help to explain residual risk of cardiovascular events in the general population. Thus, achieving a better understanding of CKD–MBDs could provide substantial insight into future treatments for arteriosclerosis and osteoporosis, which are strongly associated with ageing and morbidity in the general population. © 2018 Elsevier Ltd
Filiaciones:
Covic A.:
Department of Nephrology, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
Vervloet M.:
Department of Nephrology and Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
Massy Z.A.:
Division of Nephrology, Ambroise Paré Hospital, Paris Ile de France Ouest Université, Paris, France
Inserm U1018, Université Paris-Saclay, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France
Torres P.U.:
Department of Nephrology and Dialysis, Ramsay-Générale de Santé, Necker Hospital, University of Paris Descartes, Paris, France
Goldsmith D.:
St George's Univeristy Hospital, London, United Kingdom
Brandenburg V.:
Department of Cardiology and Intensive Care Medicine, RWTH University Hospital, Aachen, Germany
Mazzaferro S.:
Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
Evenepoel P.:
Department of Medicine, Division of Nephrology, Dialysis and Renal Transplantation, University Hospital Leuven, Leuven, Belgium
Bover J.:
Fundació Puigvert, IIB Sant Pau, REDinREN, Barcelona, Spain
Apetrii M.:
Department of Nephrology, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
Cozzolino M.:
Department of Health Sciences, Renal Division, San Paolo Hospital, University of Milan, Milan, Italy
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