TY - JOUR
T1 - Bone and mineral disorders in chronic kidney disease: implications for cardiovascular health and ageing in the general population
T2 - Implications for cardiovascular health and ageing in the general population
AU - Covic, Adrian
AU - Vervloet, Marc
AU - Massy, Ziad A.
AU - Torres, Pablo Ureña
AU - Goldsmith, David
AU - Brandenburg, Vincent
AU - Mazzaferro, Sandro
AU - Evenepoel, Pieter
AU - Bover, Jordi
AU - Apetrii, Mugurel
AU - Cozzolino, Mario
PY - 2018/4/1
Y1 - 2018/4/1
N2 - The patient with chronic kidney disease (CKD) represents an extreme model for arteriosclerosis, vascular calcification, and bone disorders, all of which are also associated with ageing in the general population. These pathological features are also relevant to other common chronic health disorders such as diabetes, and chronic inflammatory and cardiovascular diseases. Although management and interventions for these major risk factors are now incorporated into most public health guidelines (eg, smoking cessation and control of bodyweight and blood pressure, as well as glucose and cholesterol concentrations), some residual cardiovascular risk is not reduced by implementation of these interventions. CKD should be regarded as an atypical disease in which both traditional and novel cardiovascular risk factors have effects on outcomes. But CKD can also be viewed conceptually as an accelerator of traditional cardiovascular risk factors. Findings from research into mineral bone disorder associated with CKD (CKD–MBD) could help the medical community to better understand the vascular actions of certain molecules, such as phosphates, fibroblast growth factor 23, parathyroid hormone, sclerostin, or vitamin D and their relevance to the management of different pathologies in the general population. Importantly, these components, which are recognised in nephrology, could help to explain residual risk of cardiovascular events in the general population. Thus, achieving a better understanding of CKD–MBDs could provide substantial insight into future treatments for arteriosclerosis and osteoporosis, which are strongly associated with ageing and morbidity in the general population.
AB - The patient with chronic kidney disease (CKD) represents an extreme model for arteriosclerosis, vascular calcification, and bone disorders, all of which are also associated with ageing in the general population. These pathological features are also relevant to other common chronic health disorders such as diabetes, and chronic inflammatory and cardiovascular diseases. Although management and interventions for these major risk factors are now incorporated into most public health guidelines (eg, smoking cessation and control of bodyweight and blood pressure, as well as glucose and cholesterol concentrations), some residual cardiovascular risk is not reduced by implementation of these interventions. CKD should be regarded as an atypical disease in which both traditional and novel cardiovascular risk factors have effects on outcomes. But CKD can also be viewed conceptually as an accelerator of traditional cardiovascular risk factors. Findings from research into mineral bone disorder associated with CKD (CKD–MBD) could help the medical community to better understand the vascular actions of certain molecules, such as phosphates, fibroblast growth factor 23, parathyroid hormone, sclerostin, or vitamin D and their relevance to the management of different pathologies in the general population. Importantly, these components, which are recognised in nephrology, could help to explain residual risk of cardiovascular events in the general population. Thus, achieving a better understanding of CKD–MBDs could provide substantial insight into future treatments for arteriosclerosis and osteoporosis, which are strongly associated with ageing and morbidity in the general population.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85031506291&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29050900
UR - http://www.scopus.com/inward/record.url?scp=85031506291&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/S2213-8587(17)30310-8
DO - https://doi.org/10.1016/S2213-8587(17)30310-8
M3 - Review article
C2 - 29050900
SN - 2213-8587
VL - 6
SP - 319
EP - 331
JO - Lancet. Diabetes and endocrinology
JF - Lancet. Diabetes and endocrinology
IS - 4
ER -