Kidney and Metabolic Bone Diseases Vol.25 No.4(4)

Theme Clinical practice guideline for CKD-MBD
Title CKD-MBD guidelines and cardiovascular systems health
Publish Date 2012/10
Author Hideki Fujii Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
[ Summary ] Mineral bone disorder, especially hyperphosphatemia, is associated with cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). It is thought that the major cause of CVD is due to vascular calcification related to CKD. Hyperphosphatemia induces vascular calcification through cellar apoptosis and transformation from vascular smooth muscle cells into osteoblast-like cells. Recently, it has been reported that fibroblast growth factor23 and Klotho are also associated with vascular calcification. In addition, left ventricular hypertrophy (LVH) is an important risk factor for mortality in patients with CKD. Hyperphosphatemia, hyperparathyroidism, impaired vitamin D and FGF23 are all thought to be associated with LVH in these patients. Thus, it seems to be important for patients with CKD to adequately control mineral bone disorder conditions.
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