Nephrol Dial Transplant (1999) 14: 2085-2087
© 1999 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Hyperphosphataemia—a silent killer of patients with renal failure?
1 Department of Pathology and 2 Department of Internal Medicine, Ruperto Carola University, Heidelberg, Germany and 3 Hôpital Manhes, Fleury Mérogis, France
Correspondence and offprint requests to: E. Ritz, Sektion Nephrologie, Medizinische Universitätsklinik, Bergheimer Strasse 56a, D-69115 Heidelberg, Germany.
Introduction
For decades, it has been known that patients with end-stage renal failure have an excessive coronary and cardiac risk. There is also widespread consensus that coronary atherosclerosis and its complications are not fully explained by classical risk factors, e.g. dyslipidaemia, elevated homocysteine concentrations, hypertension, insulin resistance, high fibrinogen etc.
Studies on uraemia spring many surprises. In an early investigation, the paradoxical finding had been made [1] that high cholesterol concentrations are predictive of better survival. This observation subsequently has been confirmed [2] and the paradox is presumably explained by the fact that high cholesterol is a surrogate marker for adequate nutrition. Conversely, malnutrition turned out to be highly predictive of
Hyperphosphataemia and coronary plaques
Potential mechanisms of cardiac changes induced by hyperphosphataemia
Clinical implications
Where does all this leave us today?
Acknowledgments
Notes
References
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