title: Phosphate and cardiovascular disease.
abstract: Hyperphosphatemia is a major risk factor for death, CVE, and vascular calcification among patients with and without kidney disease. Even serum phosphate levels within the "normal laboratory range" associate with a greater risk of death and CVE. Potential mechanisms by which increased phosphate results in adverse outcomes are not fully understood, but current evidence suggests a direct effect of phosphate on vascular calcification and modulation of key hormones fibroblast growth factor-23 and calcitriol. Despite convincing epidemiologic connections between phosphate excess and cardiovascular disease, no clinical trials have been conducted to establish a causal relationship, and large, randomized trials with hard endpoints are urgently needed to prove or disprove the benefits and risks of therapy.
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, USA. Jessica.Kendrick@ucdenver.edu
authors.forename: Jessica
authors.initials: J
authors.lastname: Kendrick
authors.forename: Bryan
authors.initials: B
authors.lastname: Kestenbaum
authors.forename: Michel
authors.initials: M
authors.lastname: Chonchol
mesh_terms: D002114:Calcinosis / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism*; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D010710:Phosphates / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology* / Q000628:therapy; D012307:Risk Factors; D014807:Vitamin D / Q000378:metabolism
chemical_list: D010710:Phosphates; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23