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The clinical significance of vascular calcification in young patients with end-stage renal disease

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Abstract

Mortality statistics of young adults with childhood-onset end-stage renal disease (ESRD) show that cardiovascular disease (CVD) is responsible for most deaths on dialysis and after transplantation. This is most likely explained by the presence of a multitude of traditional and non-traditional risk factors in uremia, promoting the combination of classical atherosclerosis, uremic vasculopathy, and uremic cardiomyopathy. Vascular (arterial) calcifications occur with a high prevalence in young adults and their presence correlates with non-traditional risk factors, markers of inflammation, intake of calcium-containing phosphate binders, and the calcium-phosphorus product in serum. This might be explained by a high positive calcium and phosphorus balance in ESRD patients, which may be comparatively higher in the young. In addition, treatment with active vitamin D preparations may enhance the positive calcium and phosphorus balance and have a direct calcifying effect on the arterial wall. The biological process of vascular calcification resembles osteogenesis. These data indicate that vascular calcifications are related to non-traditional risk factors, inflammatory mechanisms, and disturbances in calcium and phosphorus metabolism in uremia. They provide strong evidence for a change in the current management of renal osteodystrophy in children and adolescents with ESRD.

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  1. Department of Pediatric Nephrology, Charité Children’s Hospital, 13353 Berlin, Germany

    Uwe Querfeld

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  1. Uwe Querfeld
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Correspondence to Uwe Querfeld.

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Querfeld, U. The clinical significance of vascular calcification in young patients with end-stage renal disease. Pediatr Nephrol 19, 478–484 (2004). https://doi.org/10.1007/s00467-004-1450-z

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  • DOI: https://doi.org/10.1007/s00467-004-1450-z

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