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Calcium loading, calcium accumulation, and associated cardiovascular risks in dialysis patients.

Abstract

Calcium and phosphate imbalances are important mutable risk factors for cardiovascular disease in chronic kidney disease (CKD). Nearly all dialysis patients require phosphate binders. These include traditional calcium-based compounds and, more recently, the calcium-free, metal-free, non-absorbed agent, sevelamer hydrochloride. Both binder types reduce serum phosphorus, but differ with respect to calcium load and metabolism. Absorption from calcium-based agents very likely promotes positive total calcium balance in many patients. Positive calcium balance is inappropriate in adults and may promote or accelerate soft-tissue and vascular calcification even in the absence of hypercalcemia. Calcium accumulation in heart and vascular tissues contributes to rapidly progressive cardiovascular calcification - a strong predictor of cardiovascular and all-cause mortality in stage 5 CKD. More than two-thirds of stage 5 CKD patients have calcification scores above the 75th percentile for matched controls -- scores associated with extremely high risk of cardiovascular events and death.

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  • Publisher Full Text
  • Authors+Show Affiliations

    University North Carolina, Division of Nephrology and Hypertension, Chapel Hill, NC 27514, USA. philip_klemmer@med.unc.edu

    Source

    Blood purification 23 Suppl 1: 2005 pg 12-9

    MeSH

    Calcium
    Cardiovascular Diseases
    Dialysis
    Humans
    Kidney Failure, Chronic
    Phosphates
    Risk

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    15832018

    Citation

    Klemmer, Philip J.. "Calcium Loading, Calcium Accumulation, and Associated Cardiovascular Risks in Dialysis Patients." Blood Purification, vol. 23 Suppl 1, 2005, pp. 12-9.
    Klemmer PJ. Calcium loading, calcium accumulation, and associated cardiovascular risks in dialysis patients. Blood Purif. 2005;23 Suppl 1:12-9.
    Klemmer, P. J. (2005). Calcium loading, calcium accumulation, and associated cardiovascular risks in dialysis patients. Blood Purification, 23 Suppl 1, pp. 12-9.
    Klemmer PJ. Calcium Loading, Calcium Accumulation, and Associated Cardiovascular Risks in Dialysis Patients. Blood Purif. 2005;23 Suppl 1:12-9. PubMed PMID: 15832018.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Calcium loading, calcium accumulation, and associated cardiovascular risks in dialysis patients. A1 - Klemmer,Philip J, PY - 2005/4/16/pubmed PY - 2005/7/1/medline PY - 2005/4/16/entrez SP - 12 EP - 9 JF - Blood purification JO - Blood Purif. VL - 23 Suppl 1 N2 - Calcium and phosphate imbalances are important mutable risk factors for cardiovascular disease in chronic kidney disease (CKD). Nearly all dialysis patients require phosphate binders. These include traditional calcium-based compounds and, more recently, the calcium-free, metal-free, non-absorbed agent, sevelamer hydrochloride. Both binder types reduce serum phosphorus, but differ with respect to calcium load and metabolism. Absorption from calcium-based agents very likely promotes positive total calcium balance in many patients. Positive calcium balance is inappropriate in adults and may promote or accelerate soft-tissue and vascular calcification even in the absence of hypercalcemia. Calcium accumulation in heart and vascular tissues contributes to rapidly progressive cardiovascular calcification - a strong predictor of cardiovascular and all-cause mortality in stage 5 CKD. More than two-thirds of stage 5 CKD patients have calcification scores above the 75th percentile for matched controls -- scores associated with extremely high risk of cardiovascular events and death. SN - 0253-5068 UR - https://www.unboundmedicine.com/medline/citation/15832018/full_citation L2 - https://www.karger.com?DOI=10.1159/000083713 DB - PRIME DP - Unbound Medicine ER -