Updates on the Mechanisms and the Care of Cardiovascular Calcification in Chronic Kidney Disease
Updates on the Mechanisms and the Care of Cardiovascular Calcification in Chronic Kidney Disease
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DOI：
10.1016/j.semnephrol.2018.02.004
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发表时间：
2018-05-01
影响因子：
3.3
通讯作者：
Massy, Ziad A.
中科院分区：
文献类型：
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作者：
Henaut, Lucie;Chillon, Jean-Marc;Massy, Ziad A.
在慢性肾脏病（CKD）中，肾功能的进行性下降导致矿物质代谢紊乱，通常引起继发性甲状旁腺功能亢进。血清甲状旁腺激素升高与血清钙和骨化三醇水平降低和/或血清成纤维细胞生长因子-23和磷酸盐水平升高相关。所导致的CKD相关矿物质和骨代谢紊乱与各种其他代谢失调相关，如酸中毒、营养不良、炎症和尿毒症毒素积累。它有利于血管钙化的发生，这是由于软组织矿化的许多抑制剂和促进剂之间的不平衡。本文综述了CKD患者血管钙化发生机制的最新研究进展。它进一步提出了潜在的新治疗靶点的方向。Semin Nephrol 38：233-250（C）2018 Elsevier Inc. All rights reserved.
In chronic kidney disease (CKD), the progressive decrease in renal function leads to disturbances of mineral metabolism that generally cause secondary hyperparathyroidism. The increase in serum parathyroid hormone is associated with reduced serum calcium and calcitriol levels and/or increased serum fibroblast growth factor-23 and phosphate levels. The resulting CKD-associated disorder of mineral and bone metabolism is associated with various other metabolic dysregulations such as acidosis, malnutrition, inflammation, and accumulation of uremic toxins. It favors the occurrence of vascular calcification, which results from an imbalance between numerous inhibitors and promoters of soft-tissue mineralization. This review provides an overview of the most recent state of knowledge concerning the mechanisms that lead to the development of vascular calcification in the CKD setting. It further proposes directions for potential new therapeutic targets. Semin Nephrol 38:233-250 (C) 2018 Elsevier Inc. All rights reserved.