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Vascular Calcification and Renal Bone Disorders

Authors :
Kuo-Cheng Lu
Chia-Chao Wu
Jen-Fen Yen
Wen-Chih Liu
Source :
The Scientific World Journal, Vol 2014 (2014)
Publication Year :
2014
Publisher :
Hindawi Limited, 2014.

Abstract

At the early stage of chronic kidney disease (CKD), the systemic mineral metabolism and bone composition start to change. This alteration is known as chronic kidney disease-mineral bone disorder (CKD-MBD). It is well known that the bone turnover disorder is the most common complication of CKD-MBD. Besides, CKD patients usually suffer from vascular calcification (VC), which is highly associated with mortality. Many factors regulate the VC mechanism, which include imbalances in serum calcium and phosphate, systemic inflammation, RANK/RANKL/OPG triad, aldosterone, microRNAs, osteogenic transdifferentiation, and effects of vitamins. These factors have roles in both promoting and inhibiting VC. Patients with CKD usually have bone turnover problems. Patients with high bone turnover have increase of calcium and phosphate release from the bone. By contrast, when bone turnover is low, serum calcium and phosphate levels are frequently maintained at high levels because the reservoir functions of bone decrease. Both of these conditions will increase the possibility of VC. In addition, the calcified vessel may secrete FGF23 and Wnt inhibitors such as sclerostin, DKK-1, and secreted frizzled-related protein to prevent further VC. However, all of them may fight back the inhibition of bone formation resulting in fragile bone. There are several ways to treat VC depending on the bone turnover status of the individual. The main goals of therapy are to maintain normal bone turnover and protect against VC.

Subjects

Subjects :
Technology
Medicine
Science

Details

Language :
English
ISSN :
23566140 and 1537744X
Volume :
2014
Database :
Directory of Open Access Journals
Journal :
The Scientific World Journal
Publication Type :
Academic Journal
Accession number :
edsdoj.9c9de98e43674d86b574a50c8359be37
Document Type :
article
Full Text :
https://doi.org/10.1155/2014/637065