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Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease

Patients with chronic kidney disease (CKD) exhibit tremendously elevated risk for cardiovascular disease, particularly ischemic heart disease, due to premature vascular and cardiac aging and accelerated ectopic calcification. The presence of cardiovascular calcification associates with increased ris...

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Autores principales: Hutcheson, Joshua D., Goettsch, Claudia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097496/
https://www.ncbi.nlm.nih.gov/pubmed/37053279
http://dx.doi.org/10.1161/CIRCRESAHA.123.321760
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author Hutcheson, Joshua D.
Goettsch, Claudia
author_facet Hutcheson, Joshua D.
Goettsch, Claudia
author_sort Hutcheson, Joshua D.
collection PubMed
description Patients with chronic kidney disease (CKD) exhibit tremendously elevated risk for cardiovascular disease, particularly ischemic heart disease, due to premature vascular and cardiac aging and accelerated ectopic calcification. The presence of cardiovascular calcification associates with increased risk in patients with CKD. Disturbed mineral homeostasis and diverse comorbidities in these patients drive increased systemic cardiovascular calcification in different manifestations with diverse clinical consequences, like plaque instability, vessel stiffening, and aortic stenosis. This review outlines the heterogeneity in calcification patterning, including mineral type and location and potential implications on clinical outcomes. The advent of therapeutics currently in clinical trials may reduce CKD-associated morbidity. Development of therapeutics for cardiovascular calcification begins with the premise that less mineral is better. While restoring diseased tissues to a noncalcified homeostasis remains the ultimate goal, in some cases, calcific mineral may play a protective role, such as in atherosclerotic plaques. Therefore, developing treatments for ectopic calcification may require a nuanced approach that considers individual patient risk factors. Here, we discuss the most common cardiac and vascular calcification pathologies observed in CKD, how mineral in these tissues affects function, and the potential outcomes and considerations for therapeutic strategies that seek to disrupt the nucleation and growth of mineral. Finally, we discuss future patient-specific considerations for treating cardiac and vascular calcification in patients with CKD—a population in need of anticalcification therapies.
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spelling pubmed-100974962023-04-13 Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease Hutcheson, Joshua D. Goettsch, Claudia Circ Res Compendium On Increased Risk of Cardiovascular Complications in Chronic Kidney Disease Patients with chronic kidney disease (CKD) exhibit tremendously elevated risk for cardiovascular disease, particularly ischemic heart disease, due to premature vascular and cardiac aging and accelerated ectopic calcification. The presence of cardiovascular calcification associates with increased risk in patients with CKD. Disturbed mineral homeostasis and diverse comorbidities in these patients drive increased systemic cardiovascular calcification in different manifestations with diverse clinical consequences, like plaque instability, vessel stiffening, and aortic stenosis. This review outlines the heterogeneity in calcification patterning, including mineral type and location and potential implications on clinical outcomes. The advent of therapeutics currently in clinical trials may reduce CKD-associated morbidity. Development of therapeutics for cardiovascular calcification begins with the premise that less mineral is better. While restoring diseased tissues to a noncalcified homeostasis remains the ultimate goal, in some cases, calcific mineral may play a protective role, such as in atherosclerotic plaques. Therefore, developing treatments for ectopic calcification may require a nuanced approach that considers individual patient risk factors. Here, we discuss the most common cardiac and vascular calcification pathologies observed in CKD, how mineral in these tissues affects function, and the potential outcomes and considerations for therapeutic strategies that seek to disrupt the nucleation and growth of mineral. Finally, we discuss future patient-specific considerations for treating cardiac and vascular calcification in patients with CKD—a population in need of anticalcification therapies. Lippincott Williams & Wilkins 2023-04-14 2023-04-14 /pmc/articles/PMC10097496/ /pubmed/37053279 http://dx.doi.org/10.1161/CIRCRESAHA.123.321760 Text en © 2023 The Authors. https://creativecommons.org/licenses/by-nc-nd/4.0/Circulation Research is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial-NoDerivs (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited, the use is noncommercial, and no modifications or adaptations are made.
spellingShingle Compendium On Increased Risk of Cardiovascular Complications in Chronic Kidney Disease
Hutcheson, Joshua D.
Goettsch, Claudia
Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease
title Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease
title_full Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease
title_fullStr Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease
title_full_unstemmed Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease
title_short Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease
title_sort cardiovascular calcification heterogeneity in chronic kidney disease
topic Compendium On Increased Risk of Cardiovascular Complications in Chronic Kidney Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097496/
https://www.ncbi.nlm.nih.gov/pubmed/37053279
http://dx.doi.org/10.1161/CIRCRESAHA.123.321760
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