Bone: A new endocrine organ at the heart of chronic kidney disease and mineral and bone disorders
Por:
Vervloet M.G., Massy Z.A., Brandenburg V.M., Mazzaferro S., Cozzolino M., Ureña-Torres P., Bover J., Goldsmith D.
Publicada:
1 ene 2014
Resumen:
Recent reports of several bone-derived substances, some of which have hormonal properties, have shed new light on the bone-cardiovascular axis. Deranged concentrations of humoral factors are not only epidemiologically connected to cardiovascular morbidity and mortality, but can also be causally implicated, especially in chronic kidney disease. FGF23 rises exponentially with advancing chronic kidney disease, seems to reach maladaptive concentrations, and then induces left ventricular hypertrophy, and is possibly implicated in the process of vessel calcification. Sclerostin and DKK1, both secreted mainly by osteocytes, are important Wnt inhibitors and as such can interfere with systems for biological signalling that operate in the vessel wall. Osteocalcin, produced by osteoblasts or released from mineralised bone, interferes with insulin concentrations and sensitivity, and its metabolism is disturbed in kidney disease. These bone-derived humoral factors might place the bone at the centre of cardiovascular disease associated with chronic kidney disease. Most importantly, factors that dictate the regulation of these substances in bone and subsequent secretion into the circulation have not been researched, and could provide entirely new avenues for therapeutic intervention. © 2014 Elsevier Ltd.
Filiaciones:
Vervloet M.G.:
Department of Nephrology and Institute for Cardiovascular Research VU, VU University Medical Center, Amsterdam, Netherlands
Massy Z.A.:
Division of Nephrology, Ambroise Paré Hospital, Paris Ile de France Ouest University, Boulogne Billancourt, Paris, France
INSERM U1088, Picardie University Jules Verne, Amiens, France
Brandenburg V.M.:
Department of Cardiology and Intensive Care Medicine, RWTH University Hospital Aachen, Aachen, Germany
Mazzaferro S.:
Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
Cozzolino M.:
Department of Health Sciences, Renal Division, San Paolo Hospital, University of Milan, Milan, Italy
Ureña-Torres P.:
Department of Nephrology and Dialysis, Clinique du Landy, Department of Renal Physiology, Necker Hospital, University of Paris Descartes, Paris, France
Bover J.:
Department of Nephrology, Fundació Puigvert, IIB Sant Pau, REDinREN, Barcelona, Spain
Goldsmith D.:
King's Health Partners, AHSC, London, United Kingdom
Open Access
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