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Pathophysiology and treatment of cardiovascular disease in pediatric chronic kidney disease

Life expectancy in patients with all stages of chronic kidney disease (CKD) falls far short of that in the general population. Cardiovascular disease is the leading cause of mortality in pediatric patients with CKD. In contrast to the intimal atherosclerotic lesions that characterize cardiovascular... Full description

Journal Title: Pediatric nephrology (Berlin West), 2017, Vol.34 (1), p.1-10
Main Author: Khouzam, Nadine
Other Authors: Wesseling-Perry, Katherine
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0931-041X
Link: https://www.ncbi.nlm.nih.gov/pubmed/28939921
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title: Pathophysiology and treatment of cardiovascular disease in pediatric chronic kidney disease
format: Article
creator:
  • Khouzam, Nadine
  • Wesseling-Perry, Katherine
subjects:
  • Age Factors
  • Arteries - pathology
  • Arteriosclerosis
  • Bone and Bones - metabolism
  • Calcification
  • Calcification (ectopic)
  • Calcimimetic Agents - therapeutic use
  • Cardiovascular Agents - therapeutic use
  • Cardiovascular disease
  • Cardiovascular diseases
  • Cardiovascular Diseases - drug therapy
  • Cardiovascular Diseases - etiology
  • Cardiovascular Diseases - pathology
  • Care and treatment
  • Chelating Agents - therapeutic use
  • Child
  • Chronic Kidney Disease-Mineral and Bone Disorder - drug therapy
  • Chronic Kidney Disease-Mineral and Bone Disorder - etiology
  • Chronic Kidney Disease-Mineral and Bone Disorder - pathology
  • Complications and side effects
  • Disease Progression
  • Endothelium, Vascular - pathology
  • Health risk assessment
  • Humans
  • Hyperparathyroidism
  • Kidney diseases
  • Kidney Transplantation
  • Kidneys
  • Life span
  • Medicine
  • Medicine & Public Health
  • Minerals - metabolism
  • Mortality
  • Nephrology
  • Osteodystrophy
  • Patients
  • Pediatric research
  • Pediatrics
  • Phenotypes
  • Renal Insufficiency, Chronic - complications
  • Renal Insufficiency, Chronic - metabolism
  • Renal Insufficiency, Chronic - therapy
  • Renal osteodystrophy
  • Review
  • Risk factors
  • Smooth muscle
  • Tunica Media - pathology
  • Urology
  • Vascular Calcification - drug therapy
  • Vascular Calcification - etiology
  • Vascular Calcification - pathology
  • Vitamin D
  • Vitamin D - therapeutic use
ispartof: Pediatric nephrology (Berlin, West), 2017, Vol.34 (1), p.1-10
description: Life expectancy in patients with all stages of chronic kidney disease (CKD) falls far short of that in the general population. Cardiovascular disease is the leading cause of mortality in pediatric patients with CKD. In contrast to the intimal atherosclerotic lesions that characterize cardiovascular disease in the general population, vascular endothelial dysfunction, medial arterial calcification, and cardiac dysfunction contribute to cardiovascular pathological conditions in CKD. The pathogenesis of these lesions, the origins of which can be identified in the absence of traditional cardiovascular risk factors, is incompletely understood. CKD-mediated vascular calcification in CKD is characterized by a transition of vascular smooth muscle cells to an osteoblast-like phenotype and altered bone and mineral metabolism are strongly linked to progressive cardiovascular disease in this population. Renal osteodystrophy therapies, including phosphate binders, vitamin D analogs, and calcimimetics, have an impact on the progression of cardiovascular disease. However, cardiovascular disease has its origins before the development of secondary hyperparathyroidism, and optimal therapeutic regimens that minimize cardiac dysfunction, vascular calcification, and early mortality remain to be defined.
language: eng
source:
identifier: ISSN: 0931-041X
fulltext: no_fulltext
issn:
  • 0931-041X
  • 1432-198X
url: Link


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titlePathophysiology and treatment of cardiovascular disease in pediatric chronic kidney disease
creatorKhouzam, Nadine ; Wesseling-Perry, Katherine
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descriptionLife expectancy in patients with all stages of chronic kidney disease (CKD) falls far short of that in the general population. Cardiovascular disease is the leading cause of mortality in pediatric patients with CKD. In contrast to the intimal atherosclerotic lesions that characterize cardiovascular disease in the general population, vascular endothelial dysfunction, medial arterial calcification, and cardiac dysfunction contribute to cardiovascular pathological conditions in CKD. The pathogenesis of these lesions, the origins of which can be identified in the absence of traditional cardiovascular risk factors, is incompletely understood. CKD-mediated vascular calcification in CKD is characterized by a transition of vascular smooth muscle cells to an osteoblast-like phenotype and altered bone and mineral metabolism are strongly linked to progressive cardiovascular disease in this population. Renal osteodystrophy therapies, including phosphate binders, vitamin D analogs, and calcimimetics, have an impact on the progression of cardiovascular disease. However, cardiovascular disease has its origins before the development of secondary hyperparathyroidism, and optimal therapeutic regimens that minimize cardiac dysfunction, vascular calcification, and early mortality remain to be defined.
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subjectAge Factors ; Arteries - pathology ; Arteriosclerosis ; Bone and Bones - metabolism ; Calcification ; Calcification (ectopic) ; Calcimimetic Agents - therapeutic use ; Cardiovascular Agents - therapeutic use ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - drug therapy ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - pathology ; Care and treatment ; Chelating Agents - therapeutic use ; Child ; Chronic Kidney Disease-Mineral and Bone Disorder - drug therapy ; Chronic Kidney Disease-Mineral and Bone Disorder - etiology ; Chronic Kidney Disease-Mineral and Bone Disorder - pathology ; Complications and side effects ; Disease Progression ; Endothelium, Vascular - pathology ; Health risk assessment ; Humans ; Hyperparathyroidism ; Kidney diseases ; Kidney Transplantation ; Kidneys ; Life span ; Medicine ; Medicine & Public Health ; Minerals - metabolism ; Mortality ; Nephrology ; Osteodystrophy ; Patients ; Pediatric research ; Pediatrics ; Phenotypes ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - metabolism ; Renal Insufficiency, Chronic - therapy ; Renal osteodystrophy ; Review ; Risk factors ; Smooth muscle ; Tunica Media - pathology ; Urology ; Vascular Calcification - drug therapy ; Vascular Calcification - etiology ; Vascular Calcification - pathology ; Vitamin D ; Vitamin D - therapeutic use
ispartofPediatric nephrology (Berlin, West), 2017, Vol.34 (1), p.1-10
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descriptionLife expectancy in patients with all stages of chronic kidney disease (CKD) falls far short of that in the general population. Cardiovascular disease is the leading cause of mortality in pediatric patients with CKD. In contrast to the intimal atherosclerotic lesions that characterize cardiovascular disease in the general population, vascular endothelial dysfunction, medial arterial calcification, and cardiac dysfunction contribute to cardiovascular pathological conditions in CKD. The pathogenesis of these lesions, the origins of which can be identified in the absence of traditional cardiovascular risk factors, is incompletely understood. CKD-mediated vascular calcification in CKD is characterized by a transition of vascular smooth muscle cells to an osteoblast-like phenotype and altered bone and mineral metabolism are strongly linked to progressive cardiovascular disease in this population. Renal osteodystrophy therapies, including phosphate binders, vitamin D analogs, and calcimimetics, have an impact on the progression of cardiovascular disease. However, cardiovascular disease has its origins before the development of secondary hyperparathyroidism, and optimal therapeutic regimens that minimize cardiac dysfunction, vascular calcification, and early mortality remain to be defined.
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1Arteries - pathology
2Arteriosclerosis
3Bone and Bones - metabolism
4Calcification
5Calcification (ectopic)
6Calcimimetic Agents - therapeutic use
7Cardiovascular Agents - therapeutic use
8Cardiovascular disease
9Cardiovascular diseases
10Cardiovascular Diseases - drug therapy
11Cardiovascular Diseases - etiology
12Cardiovascular Diseases - pathology
13Care and treatment
14Chelating Agents - therapeutic use
15Child
16Chronic Kidney Disease-Mineral and Bone Disorder - drug therapy
17Chronic Kidney Disease-Mineral and Bone Disorder - etiology
18Chronic Kidney Disease-Mineral and Bone Disorder - pathology
19Complications and side effects
20Disease Progression
21Endothelium, Vascular - pathology
22Health risk assessment
23Humans
24Hyperparathyroidism
25Kidney diseases
26Kidney Transplantation
27Kidneys
28Life span
29Medicine
30Medicine & Public Health
31Minerals - metabolism
32Mortality
33Nephrology
34Osteodystrophy
35Patients
36Pediatric research
37Pediatrics
38Phenotypes
39Renal Insufficiency, Chronic - complications
40Renal Insufficiency, Chronic - metabolism
41Renal Insufficiency, Chronic - therapy
42Renal osteodystrophy
43Review
44Risk factors
45Smooth muscle
46Tunica Media - pathology
47Urology
48Vascular Calcification - drug therapy
49Vascular Calcification - etiology
50Vascular Calcification - pathology
51Vitamin D
52Vitamin D - therapeutic use
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37Pediatrics
38Phenotypes
39Renal Insufficiency, Chronic - complications
40Renal Insufficiency, Chronic - metabolism
41Renal Insufficiency, Chronic - therapy
42Renal osteodystrophy
43Review
44Risk factors
45Smooth muscle
46Tunica Media - pathology
47Urology
48Vascular Calcification - drug therapy
49Vascular Calcification - etiology
50Vascular Calcification - pathology
51Vitamin D
52Vitamin D - therapeutic use
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issn0931-041X
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abstractLife expectancy in patients with all stages of chronic kidney disease (CKD) falls far short of that in the general population. Cardiovascular disease is the leading cause of mortality in pediatric patients with CKD. In contrast to the intimal atherosclerotic lesions that characterize cardiovascular disease in the general population, vascular endothelial dysfunction, medial arterial calcification, and cardiac dysfunction contribute to cardiovascular pathological conditions in CKD. The pathogenesis of these lesions, the origins of which can be identified in the absence of traditional cardiovascular risk factors, is incompletely understood. CKD-mediated vascular calcification in CKD is characterized by a transition of vascular smooth muscle cells to an osteoblast-like phenotype and altered bone and mineral metabolism are strongly linked to progressive cardiovascular disease in this population. Renal osteodystrophy therapies, including phosphate binders, vitamin D analogs, and calcimimetics, have an impact on the progression of cardiovascular disease. However, cardiovascular disease has its origins before the development of secondary hyperparathyroidism, and optimal therapeutic regimens that minimize cardiac dysfunction, vascular calcification, and early mortality remain to be defined.
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid28939921
doi10.1007/s00467-017-3798-x