| [ Summary ] |
It has been established that vascular diseases, particularly vascular calcification, are associated with bone diseases observed in hemodialysis patients. Hemodialysis patients often develop vascular calcification resulting from increased serum Ca x Pi products, which simultaneously affect bone tissue. Increases in serum Pi induce secondary hyperparathyroidism, resulting in the development of high turnover diseases, such as osteitis fibrosa. Increases in Ca levels may suppress bone turnover, resulting in the development of adynamic bone disease. Either of the above mentioned bone diseases, may result from increases in Ca or Pi loads in the circulatory system, stimulating vascular calcification, particularly medial calcification. Calcification of the medial layer shares mechanisms with ossification. Evidence has been accumulated to indicate that restoration of bone turnover to normal levels by normalizing serum Pi or PTH may result in better mortality rate, particularly cardiovascular mortality, in hemodialysis patients. Overall, it is suggested that there exists a significant association between bone diseases and vascular wall conditions in hemodialysis patients. |