International Journal of Nephrology

The Phosphorus and the Vascular Calcification in ESRD between Old Adventures and New Horizons


Publishing date
15 Sep 2011
Status
Published
Submission deadline
15 Mar 2011

1Department of Medicine; UOC of Nephrology, “A. Landolfi” Hospital, Via Melito snc, 83029 Solofra, Italy

2Medizinische Klinik III, Klinikum Coburn, Ketschendorfer Straße 33, 96450 Koburg, Germany

3Department of Nephrology and Urology, Federico II University, 80138 Naples, Italy

4Prince of Wales Hospital, Faculty of Medicine, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong


The Phosphorus and the Vascular Calcification in ESRD between Old Adventures and New Horizons

Description

Cardiovascular disease is the main cause of morbidity and mortality in patients with end-stage renal disease (ESRD). The mechanisms underlying this increased risk are not clearly understood. The mechanisms involved in the connection between chronic cardiovascular disease and chronic kidney disease (CKD) are probably numerous. Phosphorus and vascular calcification can be considered the causal link between them. The association between vascular calcifications, inflammation, and atherosclerosis seems to be not a simple passive precipitation but a complex problem of the mineral metabolism in CKD. It has already been shown that vascular calcifications produce an increase in the rigidity of the vascular wall with deceleration of the progression of the pulse wave and alteration of its morphology. Increasing arterial stiffness contributes to increasing ventricular afterload, decreased sub-endocardial perfusion, and increased mechanical fatigue of arteries, resulting in chronic low-grade cardiac ischemia due to increased oxygen consumption and reduced diastolic coronary flow. In fact, serum concentrations of calcium and phosphate exceed the calcium-phosphate solubility product, but precipitation in the vasculature does not normally take place because of VC inhibitors. Human and mouse studies have revealed multiple local and systemic inhibitors which are associated with reduced vascular calcification. But phosphate is probably the predominant inducer of vascular calcification, and elevated serum levels are strongly associated with increased vascular calcification and mortality. So, we are back to phosphorus, reevaluating the effects and observing, at the light of new evidence (such as the FGF and Kloto), its importance in determining the link between CKD and Chronic Heart Disease. Potential topics include, but are not limited to:

  • Phosphate metabolism in CKD stages 3–5: dietary and pharmacological control
  • Phosphorus, FGF-23 and Kloto
  • Calcium-phosphorus and blood pressure in dialysis patients
  • Vitamin D and paracalcitol for ESRD and dialysis patients
  • Inflammation and vascular calcification
  • The new guidelines on KDIGO chronic kidney disease-mineral and bone disorders (CKD-BMDs): expectations, novelty, and confirmation

Before submission authors should carefully read over the journal's Author Guidelines, which are located at http://www.hindawi.com/journals/ijn/guidelines/. Prospective authors should submit an electronic copy of their complete manuscript through the journal Manuscript Tracking System at http://mts.hindawi.com/ according to the following timetable:


Articles

  • Special Issue
  • - Volume 2011
  • - Article ID 419524
  • - Review Article

Vitamin D Receptor Activators and Clinical Outcomes in Chronic Kidney Disease

Luciana Gravellone | Maria Antonietta Rizzo | ... | Maurizio Gallieni
  • Special Issue
  • - Volume 2011
  • - Article ID 540592
  • - Review Article

Calcium Mass Balances in Bicarbonate Hemodialysis

Carlo Basile
  • Special Issue
  • - Volume 2011
  • - Article ID 364890
  • - Review Article

Clinical Significance of FGF-23 in Patients with CKD

Domenico Russo | Yuri Battaglia
  • Special Issue
  • - Volume 2011
  • - Article ID 839793
  • - Review Article

Arterial Stiffness and Dialysis Calcium Concentration

Fabrice Mac-Way | Amélie Leboeuf | Mohsen Agharazii
  • Special Issue
  • - Volume 2011
  • - Article ID 958798
  • - Review Article

Diagnostic Workup for Disorders of Bone and Mineral Metabolism in Patients with Chronic Kidney Disease in the Era of KDIGO Guidelines

Luigi Francesco Morrone | Domenico Russo | Biagio Di Iorio
  • Special Issue
  • - Volume 2011
  • - Article ID 269060
  • - Review Article

The Effect of Paricalcitol on Vascular Calcification and Cardiovascular Disease in Uremia: Beyond PTH Control

Mario Cozzolino | Florjan Mehmeti | ... | Daniele Cusi
  • Special Issue
  • - Volume 2011
  • - Article ID 701603
  • - Review Article

Treatment of Severe Metastatic Calcification and Calciphylaxis in Dialysis Patients

Saurabh K. Goel | Keith Bellovich | Peter A. McCullough
International Journal of Nephrology
 Journal metrics
Acceptance rate20%
Submission to final decision42 days
Acceptance to publication32 days
CiteScore2.600
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