Navigation Links
Readily available treatment could help prevent heart disease in kidney patients
Date:4/17/2008

The estimated 19 million Americans living with chronic kidney disease (CKD) face a high risk of death from cardiovascular disease. Recent studies have shown that a main source of this cardiovascular risk is CKD patients' high levels of blood phosphate.

Now researchers at Washington University School of Medicine in St. Louis have demonstrated that high blood phosphate directly stimulates calcification of blood vessels and that phosphate-binding drugs can decrease vascular calcification. That means drugs that reduce phosphate levels could help protect CKD patients from cardiovascular disease, according to the authors of the study, which is available online in advance of print publication in the Journal of the American Society of Nephrology.

"One of the kidney's functions is to help maintain a constant balance of phosphate in the bloodstream," says senior author Keith A. Hruska, M.D., director of the Division of Pediatric Nephrology and professor of pediatrics, of medicine and of cell biology and physiology. "When kidney failure occurs, an excess of serum phosphate develops. It turns out that high phosphate serves as a signal that stimulates cells within blood vessel walls to become bone-forming cells and to deposit calcium crystals. That produces vascular stiffness that is a cause of cardiovascular mortality."

Phosphate-binding drugs are already on the market, and based on evidence in this study and others like it, the Food and Drug Administration has recently decided to extend the label of such drugs. As a result, calcium acetate (PhosLo), sevelamer (Renagel) and lanthanum carbonate (Fosrenol) will be labeled to indicate they are approved for treatment of high serum phosphate levels in patients with CKD.

Hruska, Suresh Mathew, M.D., instructor in pediatrics, and colleagues studied mice with CKD and atherosclerosis calcified plaques in the arteries. They gave the mice phosphate-binding agents, which prevent phosphate in the diet from entering the bloodstream. This therapy decreased arterial calcification in the mice. The treatment also diminished the activity of a genetic program that stimulates blood vessel cells to become bone-forming cells.

Skeletal turnover normally allows the bones to assimilate excess phosphate, but in people with CKD, bone turnover is inhibited and excess phosphate stays in the bloodstream. There it can induce the differentiation of blood-vessel-wall cells into bone-forming cells.

Scientists previously identified a growth factor called BMP-7 (bone morphogenic factor-7) that increases skeletal bone formation. In addition to demonstrating the beneficial effect of phosphate-binding drugs, Hruska and colleagues found that giving BMP-7 to CKD mice also reduced phosphate in their bloodstreams and decreased the calcification of blood vessels.

"BMP-7 restores the ability of the skeleton to serve as a reservoir for phosphate, and in the walls of blood vessels it blocks the process of differentiation into bone-forming cells," Hruska says. "It's possible that BMP-7 also could someday be developed into a therapy for patients with CKD and have the added advantage of restoring normal skeletal function and protecting the normal physiology of blood vessels."

Hruska indicates that large-scale population studies have demonstrated that serum phosphate levels may be as important as serum cholesterol levels in predicting cardiovascular problems. The mechanism described in the study, in which the skeleton cannot absorb excess phosphates, is also present in elderly people with osteoporosis. In addition, diabetes can lead to kidney damage and high serum phosphate.

"There's a huge segment of the population affected by these problems," Mathew says. "Elderly osteoporosis patients and people with diabetes have high rates of cardiovascular disease and high levels of vascular calcification. So our findings may have importance even beyond patients with CKD."

Because the data in this study strongly suggest serum phosphate reduction could be highly effective for reducing cardiovascular risk in CKD patients, Hruska and Mathew have begun the process of establishing a clinical trial of phosphate reduction in CKD. "We're working to design a multicenter study to demonstrate that control of phosphate balance in CKD decreases cardiovascular events and increases survival," Hruska says.


'/>"/>

Contact: Gwen Ericson
ericsong@wustl.edu
314-286-0141
Washington University School of Medicine
Source:Eurekalert

Related medicine news :

1. Hospital Care in Singapore Now Available to American Patients at Pre-Negotiated, In-Network Rates Far Lower than Comparable Services in the U.S.
2. Catholic Bishops Official Available for Interview/Comment During Popes U.S. Visit
3. Health Care Workforce Experts Available to Comment on IOM Report on Aging Baby Boomers and Impending Medical System Crisis
4. Abbott FreeStyle Freedom(R) Lite Blood Glucose Monitoring System Now Available With No Coding for People With Diabetes
5. New Version of Microsoft Amalga Now Available to Hospitals and Health Systems
6. Since Governor and Legislators Agree on Value of Homecare, Advocacy Group Says Time is Now to Make it Available to More Pennsylvanians
7. Easter Seals Celebrates World Autism Awareness Day With Campaign to Highlight Nationwide Services Available to Families Living With Autism Today
8. Dissolvable Laundry Bags: Available to the Public from BedBugCentral.com
9. Easter Seals Notes Aprils Autism Awareness Month to Highlight Services Available to Families Living With Autism
10. Patients View of Hospital Care Enriches Information Available on Consumer Web Site
11. NASI Experts Available to Comment on 2008 Social Security and Medicare Trustees Reports
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating ... many ways they remain in the eye of the beholder, according to experts who ... of The American Journal of Managed Care. For the full issue, click here ...
(Date:6/26/2016)... ... June 26, 2016 , ... Many women are confused ... endometriosis. These women need a treatment plan to not only alleviate symptoms and ... help for preservation of fertility and ultimately achieving a pregnancy. The specialists at ...
(Date:6/25/2016)... TX (PRWEB) , ... June 25, 2016 , ... ... the United States, named Dr. Sesan Ogunleye, as the Medical Director of its new ... the facility Medical Director of our new Mesquite location,” said Dr. James M. Muzzarelli, ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... A recent ... that most people are unfamiliar with. The article goes on to state that individuals ... also many of these less common operations such as calf and cheek reduction. The ...
(Date:6/24/2016)... ... , ... Global law firm Greenberg Traurig, P.A. announced that 20 Florida attorneys ... peers for this recognition are considered among the top 2 percent of lawyers practicing ... members of this year’s Legal Elite Hall of Fame: Miami Shareholders Mark D. ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 If ... Leaders Scholarship is any indication, the future is in ... at www.diabetesscholars.org by the Diabetes Scholars Foundation ... the way of academic and community service excellence. ... since 2012, and continues to advocate for people with ...
(Date:6/23/2016)... , June 23, 2016  Guerbet announced today ... Inc.,s Supplier Horizon Award . One ... Guerbet was recognized for its support of Premier members ... through clinical excellence, and commitment to lower costs. ... receive this recognition of our outstanding customer service from ...
(Date:6/23/2016)... , June 23, 2016  Experian Health, ... and transforming the patient payment and care ... innovative new products and services that will ... revenue cycle offerings. These award-winning solutions will ... workflows, remain compliant in an ever-changing environment ...
Breaking Medicine Technology: