Vol. 23, Suppl. 1, 2005 Free Abstract Article (References) Article (PDF 137 KB)
Accumulation of Metals and Minerals in Chronic Kidney Disease. Editor(s): Salusky, I.B. (Los Angeles, Calif.)
Calcium Loading, Calcium Accumulation, and Associated Cardiovascular Risks in Dialysis Patients
Philip J. Klemmer University North Carolina, Division of Nephrology and Hypertension, Chapel Hill, N.C., USA Address of Corresponding Author Blood Purification 2005;23 (Suppl. 1):12-19 (DOI: 10.1159/000083713)
Key Words ? ? ? ? ? ?
Calcification Calcium balance Calcium load Cardiovascular disease Hyperphosphatemia Phosphate binder
Abstract Calcium and phosphate imbalances are important mutable risk factors for cardiovascular disease in chronic kidney disease (CKD). Nearly all dialysis patients require phosphate binders. These include traditional calcium-based compounds and, more recently, the calcium-free, metal-free, non-absorbed agent, sevelamer hydrochloride. Both binder types reduce serum phosphorus, but differ with respect to calcium load and metabolism. Absorption from calcium-based agents very likely promotes positive total calcium balance in many patients. Positive calcium balance is inappropriate in adults and may promote or accelerate soft-tissue and vascular calcification even in the absence of hypercalcemia. Calcium accumulation in heart and vascular tissues contributes to rapidly progressive cardiovascular calcification - a strong predictor of cardiovascular and allcause mortality in stage 5 CKD. More than two-thirds of stage 5 CKD patients have calcification scores above the 75th percentile for matched controls - scores associated with extremely high risk of cardiovascular events and death. Copyright ? 2005 S. Karger AG, Basel
Author Contacts Philip J. Klemmer, MD CB#7155 Division of Nephrology and Hypertension, University of North Carolina Chapel Hill, NC 27514 (USA) Tel. +1 919 966 2561, ext. 250, Fax +1 919 966 4251 E-Mail firstname.lastname@example.org Article Information Number of Print Pages : 8 Number of Figures : 1, Number of Tables : 0, Number of References : 82