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Mineral metabolism disturbances in patients with chronic kidney disease.
Eur J Clin Invest. 2007 Aug; 37(8):607-22.EJ

Abstract

BACKGROUND

Kidney disease, especially chronic kidney disease (CKD), is a worldwide public health problem with serious adverse health consequences for affected individuals. Secondary hyperparathyroidism, a disorder characterized by elevated serum parathyroid hormone levels, and alteration of calcium and phosphorus homeostasis are common metabolic complications of CKD that may impact cardiovascular health.

MATERIALS AND METHODS

Here, we systematically review published reports from recent observational studies and clinical trials that examine markers of altered mineral metabolism and clinical outcomes in patients with CKD.

RESULTS

Mineral metabolism disturbances begin early during the course of chronic kidney disease, and are associated with cardiovascular disease and mortality in observational studies. Vascular calcification is one plausible mechanism connecting renal-related mineral metabolism with cardiovascular risk. Individual therapies to correct mineral metabolism disturbances have been associated with clinical benefit in some observational studies; clinical trials directed at more comprehensive control of this problem are warranted.

CONCLUSIONS

There exists a potential to improve outcomes for patients with CKD through increased awareness of the Bone Metabolism and Disease guidelines set forth by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative. Future studies may include more aggressive therapy with a combination of agents that address vitamin D deficiency, parathyroid hormone and phosphorus excess, as well as novel agents that modulate circulating promoters and inhibitors of calcification.

Authors+Show Affiliations

University of Washington, Seattle, WA 98104-2499, USA. brk@u.washington.eduNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17635571

Citation

Kestenbaum, B, and V Belozeroff. "Mineral Metabolism Disturbances in Patients With Chronic Kidney Disease." European Journal of Clinical Investigation, vol. 37, no. 8, 2007, pp. 607-22.
Kestenbaum B, Belozeroff V. Mineral metabolism disturbances in patients with chronic kidney disease. Eur J Clin Invest. 2007;37(8):607-22.
Kestenbaum, B., & Belozeroff, V. (2007). Mineral metabolism disturbances in patients with chronic kidney disease. European Journal of Clinical Investigation, 37(8), 607-22.
Kestenbaum B, Belozeroff V. Mineral Metabolism Disturbances in Patients With Chronic Kidney Disease. Eur J Clin Invest. 2007;37(8):607-22. PubMed PMID: 17635571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mineral metabolism disturbances in patients with chronic kidney disease. AU - Kestenbaum,B, AU - Belozeroff,V, PY - 2007/7/20/pubmed PY - 2007/12/6/medline PY - 2007/7/20/entrez SP - 607 EP - 22 JF - European journal of clinical investigation JO - Eur J Clin Invest VL - 37 IS - 8 N2 - BACKGROUND: Kidney disease, especially chronic kidney disease (CKD), is a worldwide public health problem with serious adverse health consequences for affected individuals. Secondary hyperparathyroidism, a disorder characterized by elevated serum parathyroid hormone levels, and alteration of calcium and phosphorus homeostasis are common metabolic complications of CKD that may impact cardiovascular health. MATERIALS AND METHODS: Here, we systematically review published reports from recent observational studies and clinical trials that examine markers of altered mineral metabolism and clinical outcomes in patients with CKD. RESULTS: Mineral metabolism disturbances begin early during the course of chronic kidney disease, and are associated with cardiovascular disease and mortality in observational studies. Vascular calcification is one plausible mechanism connecting renal-related mineral metabolism with cardiovascular risk. Individual therapies to correct mineral metabolism disturbances have been associated with clinical benefit in some observational studies; clinical trials directed at more comprehensive control of this problem are warranted. CONCLUSIONS: There exists a potential to improve outcomes for patients with CKD through increased awareness of the Bone Metabolism and Disease guidelines set forth by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative. Future studies may include more aggressive therapy with a combination of agents that address vitamin D deficiency, parathyroid hormone and phosphorus excess, as well as novel agents that modulate circulating promoters and inhibitors of calcification. SN - 0014-2972 UR - https://www.unboundmedicine.com/medline/citation/17635571/Mineral_metabolism_disturbances_in_patients_with_chronic_kidney_disease_ L2 - https://doi.org/10.1111/j.1365-2362.2007.01840.x DB - PRIME DP - Unbound Medicine ER -