How abnormal calcium, phosphate, and parathyroid hormone relate to cardiovascular disease. (Continuing Education)

Cardiovascular disease tends to develop prematurely in patients who have chronic kidney disease (CKD). The physiological changes that specifically arise from this disease likely account for the resulting high incidence of cardiovascular mortality. Recent studies indicate that abnormal calcium, phosphate, and parathyroid hormone (PTH) levels are associated with cardiovascular disease in CKD. This new evidence suggests that an intensive approach to the prevention and treatment of these imbalances may contribute to improved survival of patients with CKD. Goal Discuss how long-term imbalances in calcium, phosphate, and parathyroid hormone relate to the development of cardiovascular disease in chronic kidney disease. Objectives 1. Discuss the prevalence of cardiovascular disease in patients with chronic kidney disease. 2. Describe how abnormal plasma calcium, phosphate and PTH levels affect cardiovascular function in patients with chronic kidney disease. 3. List new treatment goals for calcium, phosphate and PTH levels in patients on dialysis.
Mortality from cardiovascular disease in dialysis patients is 10 to 20 times higher than in the general population, with the relative risk being higher in younger patients and declining with [...]