Abstract
Vascular calcifications has been associated with bone and mineral disorders. The alterations in the serum level of calcium concentrations and phosphate are importants factors implicated in the arterial calcification in chronic kidney disease. The pathogenesis of vascular calcification is a complex mechanism and not completely clear, being able to correspond to an active process of cellular transformation and heterotopic ossification. Beyond the hypercalcemia and hyperphosphatemia, they are involved in this process changes in the metabolism of inhibitors and promoters of calcification such as fetuin A, osteopontin, osteoprotegerin, and matrix gla protein. For the diagnosis of the calcified arterial injury are available several complementary methods, a method of estimate of the cardiovascular risk based on plain radiographs of the lumbar column and another method based on simple x-rays of the pelvis and hands. Below, we will present a review approching the link between vascular calcifications and mineral disorders.
Highlights
Increasing evidence has suggested that bone metabolism disorders (BMD) in chronic kidney disease (CKD) are associated with cardiovascular calcification, which is a major cause of death; the mechanisms of such association are not completely known.[1]
Kauppila et al.[38] developed a classification index for the location, severity and progression of aortic calcification (AAC) (Abdominal Aortic Calcification), assessed by plain radiography on a lateral view of the lumbar spine, evaluating 617 individuals from the Framingham study with a 25-year follow-up. They investigated the association between this index and cardiovascular disorders in 2515 Framingham Study participants followed up for more than 20 years. They concluded from this study that the AAC investigated by means of lumbar lateral view is a subclinical marker of atherosclerosis and an independent predictor of subsequent cardiovascular morbidity and mortality.[39]
Since abdominal aortic calcification (AAC) correlates with calcification in other sites, such as the coronary arteries, and it has been shown to be significant in predicting cardiovascular events and mortality, this inexpensive and easy to perform method can be a useful alternative to the computed tomography (CT) techniques used in CKD patients.[40]
Summary
Kauppila et al.[38] developed a classification index for the location, severity and progression of AAC (Abdominal Aortic Calcification), assessed by plain radiography on a lateral view of the lumbar spine, evaluating 617 individuals from the Framingham study with a 25-year follow-up. They investigated the association between this index and cardiovascular disorders in 2515 Framingham Study participants followed up for more than 20 years. Since abdominal aortic calcification (AAC) correlates with calcification in other sites, such as the coronary arteries, and it has been shown to be significant in predicting cardiovascular events and mortality, this inexpensive and easy to perform method can be a useful alternative to the CT techniques used in CKD patients.[40]
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