Phosphate and cardiovascular disease.

Phosphate and cardiovascular disease.
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磷酸盐与心血管疾病。

DOI:
10.1053/j.ackd.2010.12.003
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发表时间:
2011-03
影响因子:
2.9
通讯作者:
Chonchol M
Chonchol M
中科院分区:
医学4区
文献类型:
--
作者:
Kendrick J;Kestenbaum B;Chonchol M

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在有和没有肾脏疾病的患者中,高磷血症是死亡、心血管事件和血管钙化的主要危险因素。即使血磷水平在“正常实验室范围”内,死亡和心血管事件的风险也会更大。磷酸盐增加导致不良结局的潜在机制尚不完全清楚,但现有证据表明,磷酸盐对血管钙化和关键激素成纤维细胞生长因子-23和骨化三醇的调节具有直接作用。尽管磷酸盐过量与心血管疾病之间有令人信服的流行病学联系,但还没有进行临床试验来确定因果关系,迫切需要具有硬终点的大型随机试验来证明或反驳治疗的好处和风险。
Hyperphosphatemia is a major risk factor for death, cardiovascular events and vascular calcification among patients with and without kidney disease. Even serum phosphate levels within the “normal laboratory range” associate with a greater risk of death and cardiovascular events. Potential mechanisms by which increased phosphate results in adverse outcomes are incompletely understood but current evidence suggests a direct effect of phosphate on vascular calcification and modulation of key hormones fibroblast growth factor-23 and calcitriol. Despite convincing epidemiologic connections between phosphate excess and cardiovascular disease, no clinical trials have been conducted to establish a causal relationship and large, randomized trials with hard endpoints are urgently needed to prove or disprove the benefits and risks of therapy.
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发表时间: 2008-08-07
期刊: The New England journal of medicine
影响因子: --
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