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慢性肾脏病患者心血管钙化的现有认识。

Current Understanding of Cardiovascular Calcification in Patients with Chronic Kidney Disease.

机构信息

Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.

出版信息

Int J Mol Sci. 2024 Sep 23;25(18):10225. doi: 10.3390/ijms251810225.

Abstract

The burden of chronic kidney disease (CKD) is increasing, posing a serious threat to human health. Cardiovascular calcification (CVC) is one of the most common manifestations of CKD, which significantly influences the morbidity and mortality of patients. The manifestation of CVC is an unusual accumulation of mineral substances containing calcium and phosphate. The main component is hydroxyapatite. Many cells are involved in this process, such as smooth muscle cells (SMCs) and endothelial cells. CVC is an osteogenic process initiated by complex mechanisms such as metabolic disorders of calcium and phosphorus minerals, inflammation, extracellular vesicles, autophagy, and micro-RNAs with a variety of signaling pathways like Notch, STAT, and JAK. Although drug therapy and dialysis technology continue to advance, the survival time and quality of life of CVC patients still face challenges. Therefore, early diagnosis and prevention of CKD-related CVC, reducing its mortality rate, and improving patients' quality of life have become urgent issues in the field of public health. In this review, we try to summarize the state-of-the-art understanding of the progression of CVC and hope that it will help in the prevention and treatment of CVC in CKD.

摘要

慢性肾脏病(CKD)的负担正在增加,对人类健康构成严重威胁。心血管钙化(CVC)是 CKD 最常见的表现之一,显著影响患者的发病率和死亡率。CVC 的表现是一种异常的矿物质物质积累,其中含有钙和磷酸盐。主要成分是羟磷灰石。许多细胞参与了这一过程,如平滑肌细胞(SMCs)和内皮细胞。CVC 是一个由多种信号通路(如 Notch、STAT 和 JAK)启动的成骨过程,涉及钙和磷矿物质代谢紊乱、炎症、细胞外囊泡、自噬和 microRNAs 等复杂机制。尽管药物治疗和透析技术不断进步,但 CVC 患者的生存时间和生活质量仍面临挑战。因此,早期诊断和预防 CKD 相关的 CVC,降低其死亡率,提高患者的生活质量,已成为公共卫生领域的紧迫问题。在这篇综述中,我们试图总结 CVC 进展的最新认识,希望有助于 CKD 中 CVC 的预防和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf68/11432307/2f339e2c9183/ijms-25-10225-g001.jpg

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