Cardiovascular calcification in end-stage renal disease.
Cardiovascular diseases are common in patients with end-stage renal disease (ESRD) and cardiovascular morbidity and mortality among dialysis patients are substantially higher than in the general population. The reasons for this high incidence are multiple. They include traditional factors such as hypertension, diabetes, dyslipidaemia, sodium overload, and elevated homocysteine levels as well as disturbances of mineral metabolism, specifically abnormalities in phosphorus and calcium homeostasis. This review will describe the specific cardiovascular complications related to calcifications in ESRD, the implications of the abnormalities of mineral metabolism in its pathogenesis and the current imaging techniques available for the detection of cardiovascular calcifications. Excess of calcium load contributes to the development of cardiac calcifications; therefore, alternative strategies to diminish exogenous calcium load should be considered in patients with ESRD.
Salusky
Isidro B
IB
Department of Pediatrics, UCLA School of Medicine, A2-331, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. isalusky@mednet.ucla.edu
Goodman
William G
WG
D002114:Calcinosis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D002118:Calcium / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism; D010758:Phosphorus / Q000378:metabolism
D010758:Phosphorus; D002118:Calcium