Issues

Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD) and vascular calcifications

Journal: Osteologie
ISSN: 1019-1291
Issue: Issues of 2008 (Vol. 17): Issue 3 2008 (103-190)
Pages: 119-122

Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD) and vascular calcifications

M. Ketteler
Nephrologische Klinik, Klinikum Coburg (Chefarzt: Prof. Dr. Markus Ketteler)

Keywords

vascular calcification, hyperphosphatemia, calcification inhibitors, CKD-MBD

Summary

Recently, a new view was taken on renal osteopathy, and it was suggested to replace this term by Chronic Kidney Disease- Mineral and Bone Disorder (CKD-MBD) leaving its historically “osteocentric” character behind. CKD-MBD should now be regarded as a syndrome which also includes the detection of arterial, valvular, and myocardial calcifications. It is generally well-recognized that with progressively decreasing kidney function the prevalence of vascular calcification increases when compared to the general population. It is also recognized that there are distinct pathophysiological disturbances involved such as hyperphosphatemia, osteogenic differentiation of the vessel wall and deficiencies of calcification inhibitors. Cardiovascular calcification is a potent risk factor in CKD patients associated with adverse clinical outcomes including cardiovascular events and death. However, there are uncertainties about the sensitivity and specificity of available imaging and functional detection tests. Further, there is uncertainty, whether altering the progression of calcification will directly impact on patient outcome in CKD patients. Finally, a definition is lacking for clinically useful algorithms on how to proceed with diagnostic and therapeutic strategies following a positive calcification test result.

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