Hyperphosphatemia of chronic kidney disease.
Observational studies have determined hyperphosphatemia to be a cardiovascular risk factor in chronic kidney disease. Mechanistic studies have elucidated that hyperphosphatemia is a direct stimulus to vascular calcification, which is one cause of morbid cardiovascular events contributing to the excess mortality of chronic kidney disease. This review describes the pathobiology of hyperphosphatemia that develops as a consequence of positive phosphate balance in chronic kidney disease and the mechanisms by which hyperphosphatemia acts on neointimal vascular cells that are stimulated to mineralize in chronic kidney disease. The characterization of hyperphosphatemia of chronic kidney disease as a distinct syndrome in clinical medicine with unique disordered skeletal remodeling, heterotopic mineralization and cardiovascular morbidity is presented.
Hruska
Keith A
KA
Department of Pediatrics, Renal Division, Washington University, St Louis, Missouri 63110, USA. Hruska_k@kids.wustl.edu
Mathew
Suresh
S
Lund
Richard
R
Qiu
Ping
P
Pratt
Raymond
R
D002114:Calcinosis / Q000209:etiology* / Q000378:metabolism / Q000401:mortality; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism / Q000401:mortality; D002908:Chronic Disease; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000209:etiology / Q000378:metabolism; D006801:Humans; D054559:Hyperphosphatemia / Q000150:complications / Q000378:metabolism* / Q000401:mortality; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism* / Q000401:mortality; D010024:Osteoporosis / Q000209:etiology / Q000378:metabolism; D010710:Phosphates / Q000378:metabolism; D013577:Syndrome
D010710:Phosphates