| Theme |
The impact of bone and Ca/Pi metabolism on vascular disease |
| Title |
Atherosclerosis and vascular calcification in hemodialysis patients |
| Author |
Naohisa Hirasaka |
Department of Internal Medicine, Wakayama Medical University |
| Author |
Yoshinori Tone |
Department of Internal Medicine, Wakayama Medical University |
| Author |
Masatoshi Mune |
Department of Internal Medicine, Wakayama Medical University |
| [ Summary ] |
Cardiovascular disease is the largest cause of mortality in hemodialysis patients. Cardiovascular mortality is five to twenty times higher in hemodialysis patients than in the general population. Atherosclerosis and vascular calcification are characteristic complications in hemodialysis patients. Oxidative stress is caused by in creased production of oxidants by leukocytes and antioxidant loss of vitamin C and E. Oxidatively modified LDL exists in the circulatory system, due to an excess of oxidative stress in hemodialysis patients. Oxidative stress is a major contributor to accelerated development of atherosclerosis. Oxidative stress is also a main cause of vascular calcification. The pattern of vascular calcification in hemodialysis patients is characterized by mineral deposition in the tunica media. It has been reported that there is obvious calcification in the aorta and arteries of MGP knockout mice. It is indicated that MGP has an inhibitory effect on the calcification of vessel walls. Lysophosphatidylcholine, which is the main constituent of oxidized LDL decreases the expression of MGP mRNA. Vitamin E provided protection from atherosclerosis and vascular calcification in hemodialysis patients. |