Phosphorus and Survival: Key Questions That Need Answers

[摘要] For more than forty years now, high serum phosphate levels, a highly prevalent condition in patients with chronic kidney disease (CKD), have been associated with the pathogenesis of secondary hyperparathyroidism, a common mineral and bone disorder (MBD).1 Recent epidemiologic and experimental studies have further amplified the role this condition plays in the larger story of CKD-MBD. Experimental studies have demonstrated that high phosphorus plays a key role in the development of vascular calcification2 and impairment of bone mass and strength, induces changes in the expression pattern of muscle and bone-related genes,3,4 and may also act as a pro-aging factor.5 In addition, clinical studies have demonstrated an association among hyperphosphatemia, vascular stiffness, and left ventricular hypertrophy.6 Taking all of the aforementioned findings together, it is reasonable to hypothesize all these untoward actions of phosphorus may ultimately affect mortality, as it has been suggested by several studies carried out in different dialysis cohorts.7,8

[学科分类] 泌尿医学

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