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2016 ; 100
(3
): 497-505
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The Kidney-Vascular-Bone Axis in the Chronic Kidney Disease-Mineral Bone
Disorder
#MMPMID26356179
Seifert ME
; Hruska KA
Transplantation
2016[Mar]; 100
(3
): 497-505
PMID26356179
show ga
The last 25 years have been characterized by dramatic improvements in short-term
patient and allograft survival after kidney transplantation. Long-term patient
and allograft survival remains limited by cardiovascular disease and chronic
allograft injury, among other factors. Cardiovascular disease remains a
significant contributor to mortality in native chronic kidney disease as well as
cardiovascular mortality in chronic kidney disease more than doubles that of the
general population. The chronic kidney disease (CKD)-mineral bone disorder (MBD)
is a syndrome recently coined to embody the biochemical, skeletal, and
cardiovascular pathophysiology that results from disrupting the complex systems
biology between the kidney, skeleton, and cardiovascular system in native and
transplant kidney disease. The CKD-MBD is a unique kidney disease-specific
syndrome containing novel cardiovascular risk factors, with an impact reaching
far beyond traditional notions of renal osteodystrophy and hyperparathyroidism.
This overview reviews current knowledge of the pathophysiology of the CKD-MBD,
including emerging concepts surrounding the importance of circulating pathogenic
factors released from the injured kidney that directly cause cardiovascular
disease in native and transplant chronic kidney disease, with potential
application to mechanisms of chronic allograft injury and vasculopathy.