Vascular Calcification Progression Is an Independent Predictor of Mortality in Patients on Haemodialysis

Gadrey, Jean; Mayor, Brice; Deléaval, Patrik; Lorriaux, Christie; Hurot, Jean-Marc; Bresson, Éric; Chazot, Charles

doi:10.1159/000431288

Cited by 13 publications

(13 citation statements)

References 38 publications

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“…This type of calcification results in the increase in systolic and decrease in diastolic blood pressure, followed by an increase in the afterload and hypertrophy of the left ventricle and the reduction of coronary blood flow in diastole. 55 These changes are associated with increased cardiovascular risk. 56 The main factor stimulating transformation of vascular smooth muscle cells (VSMC) to osteoblast-like cells is hyperphosphatemia.…”

Section: Sclerostin In Chronic Kidney Diseasementioning

confidence: 99%

Sclerostin: Intracellular mechanisms of action and its role in the pathogenesis of skeletal and vascular disorders

Pietrzyk¹,

Smertka²,

Chudek³

2017

Adv Clin Exp Med

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Sclerostin is a glycoprotein involved in the regulation of bone metabolism, exclusively secreted by osteocytes. It affects the activity of bone morphogenetic proteins (BMPs) and is an inhibitor of the Wnt/β-catenin metabolic pathway in bone cells. Osteocytes reduce the release of sclerostin in response to mechanical stimuli acting on bone, and thus promote the activation of osteogenic pathway Wnt/β-catenin in osteoblasts. This signaling pathway plays a key role in osteogenesis and bone turnover. Loss of sclerostin gene function is related to 3 different craniotubular hyperostosis processes: sclerosteosis, craniodiaphyseal dysplasia, and van Buchem disease. Additionally, experimental and clinical studies suggest that sclerostin may promote vascular calcification. Antibodies directed against sclerostin stimulate bone formation and represent a new therapeutic option in the treatment of diseases with increased bone resorption, such as osteoporosis and inflammatory diseases where there is generalized bone loss, periarticular osteoporosis, and cartilage damage, such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), and glucocorticoid-induced osteoporosis (GIO). Antibody use has the potential to offer new therapeutic approaches in the therapy of mineral and bone disorders resulting from chronic kidney disease (CKD-MBD) and vascular calcifications.

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Section: Sclerostin In Chronic Kidney Diseasementioning

confidence: 99%

Sclerostin: Intracellular mechanisms of action and its role in the pathogenesis of skeletal and vascular disorders

Pietrzyk¹,

Smertka²,

Chudek³

2017

Adv Clin Exp Med

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“…In addition, myocardial fibrosis and arrhythmia may develop because of tissue calcification. The presence of VC increases mortality …”

Section: General Considerations On Vascular Calcificationmentioning

confidence: 99%

Role of vascular calcification inhibitors in preventing vascular dysfunction and mortality in hemodialysis patients

Güngör

Koçyiğit

Yılmaz

et al. 2017

Seminars in Dialysis

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Cardiovascular events make up the primary cause of death in hemodialysis patients, and the risk for cardiovascular mortality is significantly increased by vascular calcification, a condition observed frequently in this patient population. The mechanisms underlying the pathogenesis of vascular calcification are complex, and many factors facilitate or hinder the development of calcification. In this review, we first summarize the main factors contributing to the pathogenesis of vascular calcification in patients with end-stage renal disease. We then explore the role of calcification inhibitors in the calcification process, as well as their effect on vascular dysfunction and mortality in hemodialysis patients. | INTRODUCTIONThe prevalence of cardiovascular diseases is high among patients with chronic kidney disease (CKD), 1 which increases morbidity and mortality in this population and represents a significant financial burden for both the patients and the healthcare systems. where it may occur in the intima and media layers of the blood vessels and in the cardiac valves. 12 The prevalence of coronary artery calcification is high among dialysis patients; specifically, some degree of coronary artery calcification is observed in 54%-100% of patients, well above the prevalence in the general population. 13Older age, male sex, long duration of dialysis, diabetes, hypertension, smoking, alcohol consumption, hyperphosphatemia, hypercalcemia,

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“…The results of our research are in concordance with these results. Some studies demonstrated that VC can predict the CDV mortality risk in non-renal population [ 27 , 29 ], but, especially in patients with renal failure on HD treatment [ 30 , 31 ] and on PD [ 11 , 12 ]. Several studies demonstrated that VC represent a link between renal and CDV diseases [ 17 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Mineral and bone disorders, morbidity and mortality in end-stage renal failure patients on chronic dialysis

Moldovan

Rusu

Kacsó

et al. 2016

Medicine and Pharmacy Reports

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Background and aimIn spite of numerous interventions, the control of mineral disturbances remains poor in end-stage renal failure (ESRF) patients. Chronic kidney disease - mineral and bone disorders (CKD-MBD) represent an important cause of mortality and morbidity. The aim of this study is to analyze the relationship between mineral and bone disorders (MBD) and their components impact on all-cause mortality and cardiovascular (CDV) mortality and morbidity in chronic dialysis patients.MethodsThis prospective study was carried out in a cohort of 92 randomly selected patients with ESRF treated with hemodialysis (HD) and peritoneal dialysis (PD). The data regarding demographic and clinical characteristics were recorded, including vascular disease (coronary, cerebral, peripheral). The follow-up lasted 40 months and the final evaluation included the number and causes of deaths, CDV events and disease. Serum Ca, P, ALP, iPTH, albumin, cholesterol, urea and creatinine levels were measured. The plain radiographic films of hands and pelvis evaluated all bone abnormalities suggestive of renal osteodystrophy (ROD) and peripheral vascular calcification (VC).ResultsAll-cause annual mortality represented 9.25% in HD and 9.09% in PD patients. The CDV mortality represented almost 44% in HD patients and 66% in PD patients from all deaths. There was a high prevalence of CDV diseases and events. High and low serum P levels were associated with a worse survival rate. Hypercalcaemia was associated with high risk for CDV events in HD patients. In PD patients, the relationship between increased ALP levels and all-cause mortality was significant. Other mineral markers were not predictive of the outcome in the studied patients. In the HD patients the severity of VC was associated with all-cause and CDV mortality, and with CDV events. Male gender, hypercholesterolemia, decreased URR, albumin and creatinine were identified as risk factors for all-cause mortality. The diabetics had higher death rates. Low dialysis efficacy represented a risk factor for mortality and CDV diseases and events. In PD patients, low albumin induced a higher death rate. In PD patients the death rate was similar to HD patients.ConclusionAll-cause mortality was higher than in general population, but lower than the chronic dialysis patients’ mortality reported in other studies. The death rates in HD and PD patients were similar. VC and serum P levels influenced the outcome in the HD patients – increased the risk for all-cause and CDV mortality, but also for CDV events. ALP levels influenced outcome in PD patients. There were no significant differences between HD and PD patients regarding outcome.

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Vascular Calcification Progression Is an Independent Predictor of Mortality in Patients on Haemodialysis

Cited by 13 publications

References 38 publications

Sclerostin: Intracellular mechanisms of action and its role in the pathogenesis of skeletal and vascular disorders

Sclerostin: Intracellular mechanisms of action and its role in the pathogenesis of skeletal and vascular disorders

Role of vascular calcification inhibitors in preventing vascular dysfunction and mortality in hemodialysis patients

Mineral and bone disorders, morbidity and mortality in end-stage renal failure patients on chronic dialysis

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