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:6/27/2016)... ... ... TopConsumerReviews.com recently awarded their highest five-star rating to Best Buy Eyeglasses, an ... United States and Canada wear eyeglasses. Once considered to be a purely functional part ... fashion statement. Even celebrities use glasses as a way of creating an iconic image—like ...
(Date:6/26/2016)... (PRWEB) , ... June 26, 2016 , ... On June ... sponsor of the 2016 Cereal Festival and World’s Longest Breakfast Table in Battle Creek, ... of the city’s history as home to some of the world’s leading providers of ...
(Date:6/26/2016)... ... , ... PawPaws brand pet supplements owned by Whole Health Supply ... health of felines. The formula is all-natural and is made from Chinese herbs that ... Cat Kidney Support Supplement Soft Chews are Astragalus Root Extract and Rehmannia Root ...
(Date:6/26/2016)... ... June 26, 2016 , ... Many women ... diagnosed with endometriosis. These women need a treatment plan to not only alleviate ... that can help for preservation of fertility and ultimately achieving a pregnancy. The ...
(Date:6/25/2016)... ... 25, 2016 , ... Austin residents seeking Mohs surgery services, can now turn ... to Dr. Russell Peckham for medical and surgical dermatology. , Dr. Dorsey brings specialization ... selective fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was under the direction ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 23, 2016  MedSource announced today that it ... software solution of choice.  This latest decision demonstrates ... to their clients by offering a state-of-the-art electronic ... establishes nowEDC as the EDC platform of choice ... clients.  "nowEDC has long been a preferred EDC ...
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... the "Pharmaceutical Excipients Market by Type (Organic Chemical ... Preservative), Formulation (Oral, Topical, Coating, Parenteral) - Global Forecast ... The global pharmaceutical excipients ... 2021 at a CAGR of 6.1% in the forecast ...
(Date:6/23/2016)... 23, 2016 Research and Markets has ... Market Analysis 2016 - Forecast to 2022" report to ... report contains up to date financial data derived from varied ... major trends with potential impact on the market during the ... segmentation which comprises of sub markets, regional and country level ...
Breaking Medicine Technology: