Early chronic kidney disease-mineral bone disorder stimulates vascular calcification.

Early chronic kidney disease-mineral bone disorder stimulates vascular calcification.
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DOI:
10.1038/ki.2013.271
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发表时间:
2014-01
影响因子:
19.6
通讯作者:
--
中科院分区:
医学1区
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--
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慢性肾脏病-矿物质和骨代谢紊乱(CKD-MBD)综合征是肾脏疾病极其重要的并发症。在这里,我们通过在动脉粥样硬化刺激动脉钙化的背景下开发早期 CKD 小鼠模型来测试 CKD-MBD 是否会导致早期肾衰竭中的血管钙化。 CKD 肾小球滤过减少相当于人 CKD 2 期,刺激早期血管钙化并抑制主动脉中 α-klotho (klotho) 的组织表达。此外,关键转录因子 RUNX2 的表达表明,早期 CKD 刺激了主动脉中的成骨细胞转变。发现与 klotho 成纤维细胞生长因子受体复合物 FGF23 相关的配体在假手术小鼠的血管中膜中表达。其表达在早期 CKD 中降低。骨细胞分泌蛋白、FGF23 和硬化素的循环水平升高可能与循环 klotho 水平升高有关。最后,我们观察到低周转性骨病,骨形成率的降低多于骨吸收的降低。因此,CKD-MBD 的特征是心血管危险因素、血管钙化、循环 klotho、FGF23 和硬化素水平升高以及低周转肾性骨营养不良,在早期 CKD 中建立。早期 CKD 导致血管 klotho 减少,刺激血管成骨细胞转化,骨细胞分泌蛋白增加,并抑制产生 CKD-MBD 的骨骼模型。
The chronic kidney disease-mineral and bone disorder (CKD-MBD) syndrome is an extremely important complication of kidney diseases. Here we tested whether CKD-MBD causes vascular calcification in early kidney failure by developing a mouse model of early CKD in a background of atherosclerosis stimulated arterial calcification. CKD equivalent in glomerular filtration reduction to human CKD stage 2 stimulated early vascular calcification and inhibited the tissue expression of α-klotho (klotho) in the aorta. In addition, osteoblast transition in the aorta was stimulated by early CKD as shown by the expression of the critical transcription factor, RUNX2. The ligand associated with the klotho-fibroblast growth factor receptor complex, FGF23, was found to be expressed in the vascular media of sham operated mice. Its expression was decreased in early CKD. Increased circulating levels of the osteocyte secreted proteins, FGF23, and sclerostin may have been related to increased circulating klotho levels. Finally, we observed low turnover bone disease with a reduction in bone formation rates more than bone resorption. Thus, the CKD-MBD, characterized by cardiovascular risk factors, vascular calcification, increased circulating klotho, FGF23 and sclerostin levels, and low turnover renal osteodystrophy, was established in early CKD. Early CKD caused a reduction of vascular klotho, stimulated vascular osteoblastic transition, increased osteocytic secreted proteins, and inhibited skeletal modeling producing the CKD-MBD.
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发表时间: 2008-08-07
期刊: The New England journal of medicine
影响因子: --
作者:
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发表时间: 2003-06-01
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发表时间: 2003-06-01
影响因子: 6.2
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通讯作者: Bex, F
DOI: 10.1097/01.asn.0000081664.65772.eb
发表时间: 2003-09-01
影响因子: 13.6
作者:
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通讯作者: London, GM