Mineral metabolism and cardiovascular disease in CKD
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- 作者：Hideki Fujii ; Nobuhiko Joki
- 关键词：Coronary atherosclerosis ; Left ventricular hypertrophy ; Valvular heart disease ; Aortic valve calcification ; Sudden cardiac death ; FGF23 ; Klotho ; Vitamin D ; Bradyarrhythmia
- 刊名：Clinical and Experimental Nephrology
- 出版年：2017
- 出版时间：March 2017
- 年：2017
- 卷：21
- 期：1-supp
- 页码：53-63
- 全文大小：
- 刊物类别：Medicine
- 刊物主题：Nephrology; Urology;
- 出版者：Springer Japan
- ISSN：1437-7799
- 卷排序：21
文摘
The mineral bone disorder of CKD, called Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD), has a major role in the etiology and progression of cardiovascular disease in CKD patients. Since the main emphasis in CKD-MBD is on three categories (bone abnormalities, laboratory abnormalities, and vascular calcifications), we have routinely accepted ectopic cardiovascular calcifications as a central risk factor in the pathophysiology of CKD-MBD for cardiac events. However, recent compelling evidence suggests that some CKD-MBD-specific factors other than vascular calcification might contribute to the onset of cardiovascular disease. Most notable is fibroblast growth factor-23 (FGF23), which is thought to be independently associated with cardiac remodeling. Slow progression of cardiac disorders, such as vascular calcification and cardiac remodeling, characterizes cardiac disease due to CKD-MBD. In contrast, fatal arrhythmia may be induced when QT prolongation occurs with CKD-MBD treatment, such as with lower Ca dialysate or the use of calcimimetics. Sudden onset of fatal cardiac events, such as heart failure and sudden cardiac death, due to fatal arrhythmia would be another distinctive phenomenon of CKD-MBD. This may be defined as CKD-MBD-specific cardiac complex syndrome.