| Theme |
New Insights into Uremic Conditions and Their Therapeutic Targets |
| Title |
Therapy for vascular calcification |
| Author |
Ayuko Fujiu |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| Author |
Kosaku Nitta |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| [ Summary ] |
Vascular calcification (VC) is due to atherosclerotic lesions in the intima, as well as the transformation of smooth muscle cells into osteoblast-like cells (Mönckeberg-type) in the media of the vessels. In the former, lipid accumulation and macrophage infiltration are key mechanisms, while dysregulation of calcium (Ca) and phosphate (P) metabolism are important in the latter. It is important to prescribe adequate doses of CaCO3 and vitamin D. In addition, sevelamer hydrochloride, a Ca-free P binder, is a useful tool for suppression of VC. Bisphosphonate is a therapeutic agent for osteoporosis, which is thought to reduce VC. On the other hand, the goal for lipid therapy is to reduce non-HDL cholesterol to less than 130 mg / dl, suggesting that lipid-lowering therapy may reduce VC. Basic research has shown the efficacy of vitamin K and lowered warfarin dosage in the suppression of VC. A recent report explored the dosage of calcimimetics which may be useful in reducing the progression of VC. |