Nephrol Dial Transplant (2002) 17: 1365-1368
© 2002 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Progression of vascular calcification in uraemic patients: can it be stopped?
1 Inserm U507 and Service de Néphrologie, Hôpital Necker, Paris, France and 2 Division of Nephrology, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
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Introduction
Patients with advanced renal failure may develop several types of soft tissue calcification, including visceral, articular and vascular calcification. Among the latter, the most dramatic form is calciphylaxis, also called calcific uraemic arteriolopathy, which generally has an acute course and may be rapidly lethal. In general, more slowly progressive forms prevail which are characterized by either focal, patchy deposits of calcium and phosphate in atheromatous plaques, or by diffuse deposits in the medial layer of the arterial tree. Frequently, the two forms are combined.
Pathogenetic mechanisms
Disturbances of calcium and phosphate metabolism have been shown to play a major role in the pathogenesis of arterial calcification of either type, in association with either hyperparathyroidism or hypoparathyroidism and with vitamin D overload [1,2]. Atheromatous plaques of uraemic patients are more frequently and more intensively calcified than those of non-uraemic subjects [3]. The most marked difference compared with
Beyond phosphate control: arrest of progressive vascular calcification?
Open questions
Future directions
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