title: Calcium as a cardiovascular toxin in CKD-MBD.
abstract: Disordered calcium balance and homeostasis are common in patients with chronic kidney disease. Such alterations are commonly associated with abnormal bone remodeling, directly and indirectly. Similarly, positive calcium balance may also be a factor in the pathogenesis of extra skeletal soft tissue and arterial calcification. Calcium may directly affect cardiac structure and function through direct effects to alter cell signaling due to abnormal intracellular calcium homeostasis 2) extra-skeletal deposition of calcium and phosphate in the myocardium and small cardiac arterioles, 3) inducing cardiomyocyte hypertrophy through calcium and hormone activation of NFAT signaling mechanisms, and 4) increased aorta calcification resulting in chronic increased afterload leading to hypertrophy. Similarly, calcium may alter vascular smooth muscle cell function and affect cell signaling which may predispose to a proliferative phenotype important in arteriosclerosis and arterial calcification. Thus, disorders of calcium balance and homeostasis due to CKD-MBD may play a role in the high cardiovascular burden observed in patients with CKD.
authors: Indiana University School of Medicine, Division of Nephrology, Indianapolis, IN, United States; Department of Medicine, Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States. Electronic address: smoe@iu.edu.
authors: Sharon M
authors: SM
authors: Moe
mesh_terms: D000818:Animals; D002118:Calcium / Q000378:metabolism*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000378:metabolism*; D005966:Glucuronidase / Q000378:metabolism; D006801:Humans; D000090265:Klotho Proteins; D051436:Renal Insufficiency, Chronic / Q000378:metabolism; D061205:Vascular Calcification / Q000378:metabolism
chemical_list: D005966:Glucuronidase; D000090265:Klotho Proteins; D002118:Calcium
keywords: Calcification; Calcium; Chronic kidney disease; Heart; Mineral bone disorder; Vascular smooth muscle cells