Specificities of the treatment for vascular system diseases in patients with a chronic renal disease


Authors: Petr Táborský
Published in: AtheroRev 2019; 4(3): 138-144
Category:

Overview

Chronic kidney disease is a significant risk factor for cardiovascular complications. The main cause of mortality in kidney failure is a complex vascular disease manifested as athero- and arteriosclerosis. Vascular involvement starts very early in the course of kidney disease. Besides classical risk factors the specific, uremia-related factors are in action. Most important of them is the bone and mineral disorder (CKD-MBD). Vascular wall injury is initiated by hyperphosphatemia, later on the vascular calcifications are formed. Deficit of Klotho and high concentration of phosphatonin FGF23 contribute to accelerated aging of vessels. First clinical sign of this disorder is vascular stiffness which can be quantified by pulse wave velocity measurement. CKD-MBD treatment consists of hyperphosphatemia prevention by diet, phosphate binders administration, secondary hyperparathyroidism management and phosphate removal by dialysis.

Keywords:

arteriosclerosis – bone and mineral disorder – chronic kidney disease – FGF23 – Klotho – Parathyroid hormone – phosphorus


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Labels
Angiology Diabetology Internal medicine Cardiology General practitioner for adults

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