American Journal of Kidney Diseases
Volume 52, Issue 6 , Pages 1139-1150 , December 2008

Association of Changes in Bone Remodeling and Coronary Calcification in Hemodialysis Patients: A Prospective Study

  • Daniela Veit Barreto, MD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
    • ,
  • Fellype de Carvalho Barreto, MD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
    • ,
  • Aluízio Barbosa de Carvalho, MD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
    • ,
  • Lilian Cuppari, PhD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
    • ,
  • Sérgio Antonio Draibe, MD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
    • ,
  • Maria Aparecida Dalboni, PhD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
    • ,
  • Rosa Maria Affonso Moyses, MD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, University of São Paulo, São Paulo, Brazil
    • ,
  • Kátia Rodrigues Neves, MD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, University of São Paulo, São Paulo, Brazil
    • ,
  • Vanda Jorgetti, MD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, University of São Paulo, São Paulo, Brazil
    • ,
  • Márcio Miname, MD

      Affiliations

    • The Lipid Clinic of the Instituto do Coração (InCor, Heart Institute), University of São Paulo, São Paulo, Brazil
    • ,
  • Raul D. Santos, MD

      Affiliations

    • The Lipid Clinic of the Instituto do Coração (InCor, Heart Institute), University of São Paulo, São Paulo, Brazil
    • ,
  • Maria Eugênia F. Canziani, MD

      Affiliations

    • Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
    • Corresponding Author InformationAddress correspondence to Maria Eugênia F. Canziani, MD, Rua Pedro de Toledo, 282, CEP 04039-000, São Paulo, SP, Brazil

Received 20 February 2008 ,Accepted 24 June 2008.

References 

  1. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32(suppl 3):S112–S119
  2. Schwarz U, Buzello M, Ritz E, et al. Morphology of coronary atherosclerotic lesions in patients with end-stage renal disease. Nephrol Dial Transplant. 2000;15:218–223
  3. Blacher J, Guérin AP, Pannier B, Marchais SJ, London GM. Arterial calcifications, arterial stiffness and cardiovascular risk in end-stage renal disease. Hypertension. 2001;38:938–942
  4. London GM, Marchais SJ, Guerin AP, Metivier F, Adda H. Arterial structure and function in end-stage renal disease. Nephrol Dial Transplant. 2002;17:1713–1724
  5. Vattikuti R, Towler D. Osteogenic regulation of vascular calcification: An early perspective. Am J Physiol Endocrinol Metab. 2004;286:686–696
  6. Demer L, Tintut Y, Parhami F. Novel mechanisms in accelerated vascular calcification in renal disease patients. Curr Opin Nephrol Hypertens. 2002;11:437–443
  7. Demer L, Tintut Y. Mineral exploration: Search for the mechanism of vascular calcification and beyond. Arterioscler Thromb Vasc Biol. 2003;23:1739–1743
  8. Hofbauer LC, Schoppet M. Clinical implications of the osteoprotegerin/RANKL/RANK system for bone and vascular diseases. JAMA. 2004;292:490–495
  9. Shaffer C, Heiss A, Schwarz A, et al. The serum protein alpha 2-Heremans-Schmidt glycoprotein/fetuin-A is a systemically acting inhibitor of ectopic calcification. J Clin Invest. 2003;112:357–366
  10. Moe SM, Chen XN. Mechanisms of vascular calcification in chronic kidney disease. J Am Soc Nephrol. 2008;19:213–216
  11. Giachelli CM, Jono S, Shioi A, Nishizawa Y, Mori K, Morii H. Vascular calcification and inorganic phosphate. Am J Kidney Dis. 2001;38(suppl 1):S34–S37
  12. In:  Brenner BM editors. The Kidney. Philadelphia, PA: Saunders; 2000;p. 2103–2186
  13. Barreto DV, Barreto FC, Carvalho AB, et al: Phosphate binder impact on bone remodeling and coronary calcification—results from BRiC study. Nephron (in press)
  14. Barreto DV, Barreto FC, Carvalho AB, et al. Coronary calcification in hemodialysis patients: The contribution of traditional and uremia-related risk factors. Kidney Int. 2005;67:1576–1582
  15. Blackburn GL, Thorton PA. Nutritional assessment of the hospitalized patients. Med Clin North Am. 1979;63:1103–1115
  16. Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827–832
  17. Janowitz WR, Agatston AS, Kaplan G, Viamonte M. Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women. Am J Cardiol. 1993;72:247–254
  18. Bonow RO, Brundage BH, Budoff MJ, et al. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain. Circulation. 2007;115:402–426
  19. In:  Malluche HH,  Faugere MC editor. Methodology of mineralized bone histology, in Atlas of Mineralized Bone Histology. Basel, Switzerland: Karger; 1986;p. 17–24
  20. Parfitt AM, Drezner MK, Glorieux FH, et al. Bone histomorphometry: Standardization of nomenclature, symbols, and units. Report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res. 1987;2:595–610
  21. Dos Reis LM, Batalha JR, Muñoz DR, et al. Brazilian normal static bone histomorphometry: Effects of age, sex, and race. J Bone Miner Metab. 2007;25:400–406
  22. Melsen F, Mosekilde L. Tetracycline double-labeling of trabecular bone in 41 normal adults. Calcified Tissue Res. 1978;26:99–102
  23. Moe S, Druke T, Cunningham J, et al. Definition, evaluation, and classification of renal osteodystrophy: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006;69:1945–1953
  24. Block GA, Hulbert-Shearon TE, Levin NW, Port FK. Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: A national study. Am J Kidney Dis. 1998;31:607–617
  25. Oh J, Wunsch R, Turzer M, et al. Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation. 2002;106:100–105
  26. Braun J, Oldendorf M, Moshage W, et al. Electron beam computed tomography in the evaluation of cardiac calcification in chronic dialysis patients. Am J Kidney Dis. 1996;27:394–401
  27. Goodman WG, Goldin J, Kuizon BD, et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med. 2000;342:1478–1483
  28. Stompor T, Pasowicz M, Sullowicz W, et al. An association between coronary artery calcification score, lipid profile, and selected markers of chronic inflammation in ESRD patients treated with peritoneal dialysis. Am J Kidney Dis. 2003;41:203–211
  29. Tanko LB, Bagger YZ, Christiansen C. Low bone mineral density in the hip as a marker of advanced atherosclerosis in elderly women. Calcif Tissue Int. 2003;73:15–20
  30. Kiel DP, Kauppila LI, Cupples LA, Hannan MT, O'Donnell CJ, Wilson PW. Bone loss and the progression of abdominal aortic calcification over a 25 year period: The Framingham Heart Study. Calcif Tissue Int. 2001;68:271–276
  31. Lund RJ, Davies MR, Brown AJ, Hruska KA. Successful treatment of an adynamic bone disorder with bone morphogenetic protein-7 in a renal ablation model. J Am Soc Nephrol. 2004;15:359–369
  32. Barreto FC, Barreto DV, Moyses RM, et al. Osteoporosis in hemodialysis patients revisited by bone histomorphometry: A new insight into an old problem. Kidney Int. 2006;69:1852–1857
  33. Stevenson JC. Osteoporosis and cardiovascular disease in women: Converging path. Lancet. 1990;336:1121–1122
  34. Collin-Osdoby P. Regulation of vascular calcification by osteoclast regulatory factors RANKL and osteoprotegerin. Circ Res. 2004;95:1046–1057
  35. Hak A, Pols H, van Hemert A, Hofman A, Witteman J. Progression of aortic calcification is associated with metacarpal bone loss during menopause: A population-based longitudinal study. Arterioscler Thromb Vasc Biol. 2000;20:1926–1931
  36. Hofbauer L, Schoppet M. Osteoprotegerin: A link between osteoporosis and arterial calcification?. Lancet. 2001;358:257–259
  37. Fahrleitner-Pammer A, Dobnig H, Piswanger-Soelkner C, et al. Osteoprotegerin serum levels in women: Correlation with age, bone mass, bone turnover and fracture status. Wien Klin Wochenschr. 2003;115:291–297
  38. Avbersek-Luznik I, Malesic I, Rus I, Marc J. Increased levels of osteoprotegerin in hemodialysis patients. Clin Chem Lab Med. 2002;40:1019–1023
  39. Khosla S, et al. Correlates of osteoprotegerin levels in women and men. Osteoporos Int. 2002;13:394–399
  40. Gonzalez EA, Lund RJ, Martin KJ, et al. Treatment of a murine model of high-turnover renal osteodystrophy by exogenous BMP-7. Kidney Int. 2002;61:1322–1331
  41. Neves KR, Graciolli FG, dos Reis LM, et al. Vascular calcification: Contribution of parathyroid hormone in renal failure. Kidney Int. 2007;71:1262–1270
  42. Kurz P, Monier-Faugere MC, Bognar B, et al. Evidence for abnormal calcium homeostasis in patients with adynamic bone disease. Kidney Int. 1994;46:855–856
  43. Davies MR, Lund RJ, Mathew S, Hruska KA. Low turnover osteodystrophy and vascular calcification are amenable to skeletal anabolism in an animal model of chronic kidney disease and the metabolic syndrome. J Am Soc Nephrol. 2005;16:917–928

 Originally published online as doi:10.1053/j.ajkd.2008.06.024 on September 29, 2008.

PII: S0272-6386(08)01119-0

doi: 10.1053/j.ajkd.2008.06.024

American Journal of Kidney Diseases
Volume 52, Issue 6 , Pages 1139-1150 , December 2008

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