The Key Role of Phosphate on Vascular Calcification

Overview

Journal Toxins (Basel)

Publisher MDPI

Specialty Toxicology

Date 2019 Apr 12

PMID 30970562

Citations 60

Authors

Mario Cozzolino

Paola Ciceri

Andrea Galassi

Michela Mangano

Stefano Carugo

Irene Capelli

Giuseppe Cianciolo

Affiliations

Soon will be listed here.

Abstract

Vascular calcification (VC) is common in dialysis and non-dialysis chronic kidney disease (CKD) patients, even in the early stage of the disease. For this reason, it can be considered a CKD hallmark. VC contributes to cardiovascular disease (CVD) and increased mortality among CKD patients, although it has not been proven. There are more than one type of VC and every form represents a marker of systemic vascular disease and is associated with a higher prevalence of CVD in CKD patients, as shown by several clinical studies. Major risk factors for VC in CKD include: Increasing age, dialysis vintage, hyperphosphatemia (particularly in the setting of intermittent or persistent hypercalcemia), and a positive net calcium and phosphate balance. Excessive oral calcium intake, including calcium-containing phosphate binders, increases the risk for VC. Moreover, it has been demonstrated that there is less VC progression with non-calcium-containing phosphate binders. Unfortunately, until now, a specific therapy to prevent progression or to facilitate regression of VC has been found, beyond careful attention to calcium and phosphate balance.

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