The Korean Journal of Medicine

  • 제87권1호
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  • Pages.39-41
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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혈액투석 환자에서 혈관 석회화의 임상적 의의: 결과인가 시작인가?

Clinical Implication of Vascular Calcification in Patients Undergoing Hemodialysis: The End or the Beginning of Disease

  • 김창성 (전남대학교병원 신장내과)
  • Kim, Chang Seong (Division of Nephrology, Department of Internal Medicine, Chonnam National University Hospital)
  • 발행 : 2014.07.01
⟨ 이전 논문 다음 논문 ⟩

초록

In recent years, many studies have emphasized the role of vascular calcification in the development of cardiovascular disease and its strong link to high cardiovascular mortality and low patient survival. Calcification of both the coronary and large vessels is common in patients undergoing hemodialysis. However, no consensus exists on the assessment of vascular calcification or interventions to retard its progression in patients undergoing hemodialysis. In this issue, Shin et al. investigated the correlation between the vascular calcification score of the hands and pelvis on simple radiographs and the inflammation and nutrition status of patients undergoing hemodialysis. They determined that vascular calcification is crucial and severs the vicious circle of linked risk factors, thus improving survival outcomes. In this respect, vascular calcification may not be an end to disease course, but a beginning.

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참고문헌

  1. London GM, Guerin AP, Marchais SJ, Metivier F, Pannier B, Adda H. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 2003;18:1731-1740. https://doi.org/10.1093/ndt/gfg414
  2. Russo D, Palmiero G, De Blasio AP, Balletta MM, Andreucci VE. Coronary artery calcification in patients with CRF not undergoing dialysis. Am J Kidney Dis 2004;44:1024-1030. https://doi.org/10.1053/j.ajkd.2004.07.022
  3. Briet M, Boutouyrie P, Laurent S, London GM. Arterial stiffness and pulse pressure in CKD and ESRD. Kidney Int 2012;82:388-400. https://doi.org/10.1038/ki.2012.131
  4. Seyahi N, Cebi D, Altiparmak MR, et al. Progression of coronary artery calcification in renal transplant recipients. Nephrol Dial Transplant 2012;27:2101-2107. https://doi.org/10.1093/ndt/gfr558
  5. Shin SY, Han KH, Jeong HY, et al. Vascular Calcification Scores are Associated with Arterial Stiffness, Inflammation, and Nutrition in Hemodialysis Patients. Korean J Med 2014;87:42-52. https://doi.org/10.3904/kjm.2014.87.1.42
  6. Schwarz U, Buzello M, Ritz E, et al. Morphology of coronary atherosclerotic lesions in patients with end-stage renal failure. Nephrol Dial Transplant 2000;15:218-223. https://doi.org/10.1093/ndt/15.2.218
  7. Bhan I, Thadhani R. Vascular calcification and ESRD: a hard target. Clin J Am Soc Nephrol 2009;4(Suppl 1):S102-105. https://doi.org/10.2215/CJN.04800709
  8. Zieman SJ, Melenovsky V, Clattenburg L, et al. Advanced glycation endproduct crosslink breaker (alagebrium) improves endothelial function in patients with isolated systolic hypertension. J Hypertens 2007;25:577-583. https://doi.org/10.1097/HJH.0b013e328013e7dd
  9. Barreto DV, Barreto FC, Liabeuf S, et al. Plasma interleukin-6 is independently associated with mortality in both hemodialysis and pre-dialysis patients with chronic kidney disease. Kidney Int 2010;77:550-556. https://doi.org/10.1038/ki.2009.503
  10. Shlipak MG, Fried LF, Crump C, et al. Elevations of inflammatory and procoagulant biomarkers in elderly persons with renal insufficiency. Circulation 2003;107:87-92. https://doi.org/10.1161/01.CIR.0000042700.48769.59
  11. Karohl C, D'Marco Gascon L, Raggi P. Noninvasive imaging for assessment of calcification in chronic kidney disease. Nat Rev Nephrol 2011;7:567-577. https://doi.org/10.1038/nrneph.2011.110
  12. Jimbo R, Kawakami-Mori F, Mu S, et al. Fibroblast growth factor 23 accelerates phosphate-induced vascular calcification in the absence of Klotho deficiency. Kidney Int 2014;85:1103-1111. https://doi.org/10.1038/ki.2013.332
  13. Six I, Okazaki H, Gross P, et al. Direct, acute effects of Klotho and FGF23 on vascular smooth muscle and endothelium. PLoS One 2014;9:e93423. https://doi.org/10.1371/journal.pone.0093423