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Vascular protection in renal failure |
Sang Thrombose Vaisseaux. Volume 22, Number 5, 237-45, mai 2010, Mini-revue
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 Résumé
Texte intégral
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Author(s) : Jean-Jacques Boffa |
Summary : Accelerated atherosclerosis is one of the primary causes of morbidity and mortality in patients with chronic kidney diseases (CKD). Multiples factors are incriminated in the high CV risk. In addition to a high prevalence of traditional CV risk factors such as anemia, hyperphosphatemia, hyperparathyroidism, vascular calcifications, endothelial dysfunction, arterial thickness are present in renal failure. Just as the general population, vascular protection consists of correction of CV risk factors. In contrast to the general population, the proof of treatment efficacy is often absent in this CKD population. Among specific factors, anemia should be corrected without excess. Control of phosphatemia is important to prevent vascular calcification, but the best treatment is still unclear. Vitamin D uptake contributes to limit hyperparathyroïdism, prolongs the survival in dialysis patients but high doses favour hypercalcemia. Ongoing trials test calcimimetics to reduce vascular calcifications and cardiovascular events in CKD patients. Additional therapeutic target have been identified but await novel drug development. |
Keywords : Chronic kidney diseases, cardiovascular risk factors, mineral bone disorders |
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