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Clinical management of vascular and soft tissue calcifications in chronic kidney disease patients 

Clinical management of vascular and soft tissue calcifications in chronic kidney disease patients
Chapter:
Clinical management of vascular and soft tissue calcifications in chronic kidney disease patients
Author(s):

Markus Ketteler

and Jürgen Floege

DOI:
10.1093/med/9780199559176.003.019
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date: 07 August 2020

Vascular and soft-tissue calcifications are not just a random process of passive calcium and phosphate precipitation, but involve active cellular processes influenced by the presence or absence of inhibitors and inducers. In this context, phosphate and calcium are among the key active inducers of cellular pro-calcifying pathomechanisms, especially in patients with advanced CKD. Additionally, the presence (or absence) and activity of calcification inhibitors may potently modify clinical calcification progression in CKD patients at risk. Cardiovascular calcification is amongst the strongest risk predictors of death in the CKD population, so appropriate management approaches, including phosphate lowering and avoidance of unreasonable calcium loads, are likely to improve outcomes. In the future, modifying vitamin K status, thiosulphate administration, or anti-inflammatory strategies may become additional tools in calcification-prone CKD individuals.

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