Hsu Bang-Gee, Tsai Jen-Pi
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Tzu Chi Med J. 2020 Jul 29;33(1):34-41. doi: 10.4103/tcmj.tcmj_36_20. eCollection 2021 Jan-Mar.
Vascular calcification (VC) is highly prevalent among patients with chronic kidney disease (CKD). There is growing evidence that there is more underlying this condition than the histological presentation of atherosclerotic plaque and arteriosclerosis and that the risk of cardiovascular disease in the context of CKD might be explained by the presence of VC. While VC has been observed in the absence of overt abnormal mineral metabolism, this association is coupled to abnormal homeostasis of minerals in patients with CKD, due to hyperphosphatemia and hypercalcemia. Furthermore, recent studies have shown that the differentiation of vascular smooth muscle cells into an osteogenic phenotype is highly regulated by pro-calcifying and anti-calcifying factors. There are several imaging modalities currently used in clinical practice to evaluate the extent and severity of VC; each has different advantages and limitations. Although there is no universally accepted method for the treatment of VC, there is growing evidence of the beneficial effects of medical therapy for the condition. This study discusses the mechanism underlying VC, imaging modalities used for evaluation of the condition, and possible treatments.
血管钙化（VC）在慢性肾脏病（CKD）患者中非常普遍。越来越多的证据表明，这种情况的潜在原因不止动脉粥样硬化斑块和动脉硬化的组织学表现，而且CKD患者心血管疾病的风险可能可以用VC的存在来解释。虽然在没有明显异常矿物质代谢的情况下也观察到了VC，但由于高磷血症和高钙血症，这种关联与CKD患者矿物质的异常稳态有关。此外，最近的研究表明，血管平滑肌细胞向成骨表型的分化受到促钙化和抗钙化因子的高度调节。目前临床实践中使用几种成像方式来评估VC的程度和严重程度；每种方式都有不同的优点和局限性。虽然目前尚无普遍接受的VC治疗方法，但越来越多的证据表明药物治疗对该病症有有益效果。本研究讨论了VC的潜在机制、用于评估该病症的成像方式以及可能的治疗方法。
