Fibroblast Growth Factor 23, Cardiovascular Disease, and Inflammation

[摘要] Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with CKD (1,2). There is clear evidence that in patients with CKD on dialysis, the major cause for mortality, morbidity, and hospitalization is relentless CVD (3). This excess cardiovascular risk is also evident in patients with CKD not yet on dialysis (4,5). The cardiovascular risk factors in the population of patients with CKD can be separated somewhat arbitrarily into traditional risk factors such as hypertension, hyperlipidemia, diabetes mellitus, and family history and a group of risk factors more prevalent in patients with kidney disease, which have been grouped into what is called nontraditional risk factors such as positive calcium and phosphorus mineral balance, secondary hyperparathyroidism, renal osteodystrophy, vascular calcification, vitamin D insufficiency, and more recently described, elevated levels of fibroblast growth factor 23 (FGF23) (6). This collection of abnormalities has also been labeled as the CKD-mineral bone disorder (CKD-MBD) syndrome, with vascular calcification representing one of the most significant risk factors. The majority of patients with CKD overlap these traditional and nontraditional risk factors and have some features of all of them. Patients on dialysis almost uniformly have vascular calcification at the start of dialysis, and the condition progressively worsens with time on renal replacement therapy.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome