[Clinical advances in vascular calcification].
The articles providing answers to the questions on vascular calcification of most interest from a clinical point of view were selected. 1. How is it measured?: Studies showing the clinical utility of different tools to quantify it were analyzed. 2. What does it measure?: Both in dialysis patients and the general population, vascular calcification and arterial stiffness are prognostic factors for morbidity and mortality. Other markers such as fetuin-A are associated with mortality in patients on hemodialysis but not in patients in early stages of chronic kidney disease. 3. What causes it?: In two selected studies, it was demonstrated again that low bone turnover and diabetes cause cardiovascular disease and vascular calcification, respectively. 4. How is it treated?: There is still no clinical evidence of regression of vascular calcification. However, a prospective study in new hemodialysis patients showed that sevelamer compared to calcium compounds slows the progression of vascular calcification and confers greater survival. A study comparing both compounds in chronic hemodialysis patients showed that sevelamer only had a benefit on survival in patients older than 65 years. It remains to be demonstrated whether the good experimental results of paricalcitol and cinacalcet are confirmed in prospective clinical studies.
Fernández Giráldez
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Servicio de Nefrologia, Hospital Arnau de Vilanova (IRB Lleida), Spain.
D000368:Aged; D000818:Animals; D050197:Atherosclerosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D002114:Calcinosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D002908:Chronic Disease; D000069449:Cinacalcet; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D048909:Diabetes Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D004872:Ergocalciferols / Q000627:therapeutic use; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D054559:Hyperphosphatemia / Q000150:complications; D007674:Kidney Diseases / Q000150:complications; D051379:Mice; D018345:Mice, Knockout; D015337:Multicenter Studies as Topic; D009281:Naphthalenes / Q000627:therapeutic use; D011073:Polyamines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012077:Renal Artery / Q000473:pathology; D000069603:Sevelamer; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control
D004872:Ergocalciferols; D009281:Naphthalenes; D011073:Polyamines; C084656:paricalcitol; D000069603:Sevelamer; D000069449:Cinacalcet
Avances clínicos en calcificación vascular.