[Cardiovascular effects of VDR and CaSR activation].
Cardiovascular complications are the most common cause of death in uremic patients, especially those on chronic dialysis. One of the major findings is massive calcium deposition in the vessel walls. There is general consensus about the correlation between the distribution of vascular calcification and increased risk of death due to cardiovascular disease. An emerging issue is the possible beneficial role of vitamin D receptor (VDR) activation in reducing the morbidity and mortality rates in patients on chronic dialysis, as shown in large, although retrospective, studies. Still open is the possible role of CaSR activators in ameliorating the clinical course of patients on dialysis, although calcimimetics are able to improve the Ca-P-PTH serum profile and increase the number of patients within the international guidelines parameters. This review has been structured to give the readers an updated opinion on the possible positive impact of VDR and CaSR activators in terms of all-cause and cardiovascular morbidity and mortality in dialysis patients.
Brancaccio
D
D
Cattedra di Nefrologia, Universita' degli Studi, Milano and Unita' di Nefrologia e Centro Dialisi Simone Martini, Milano - Italy. diego.brancaccio@unimi.it
Cozzolino
M
M
D002114:Calcinosis / Q000150:complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002117:Calcitriol / Q000627:therapeutic use*; D002120:Calcium Channel Agonists / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000517:prevention & control; D018167:Receptors, Calcitriol / Q000378:metabolism*; D044169:Receptors, Calcium-Sensing / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects; D012306:Risk; D016896:Treatment Outcome; D014511:Uremia / Q000150:complications
D002120:Calcium Channel Agonists; D018167:Receptors, Calcitriol; D044169:Receptors, Calcium-Sensing; D002117:Calcitriol