Chapter

Clinical consequences of arterial calcifications and soft-tissue calcifications in chronic kidney disease

Gérard M. London, Bruno Pannier, Alain P. Guerin and Sylvain J. Marchais

in The Spectrum of Mineral and Bone Disorders in Chronic Kidney Disease

Second edition

Published on behalf of Oxford University Press

Published in print June 2010 | ISBN: 9780199559176
Published online November 2012 | e-ISBN: 9780191753350 | DOI: http://dx.doi.org/10.1093/med/9780199559176.003.018

Series: Oxford Clinical Nephrology Series

Clinical consequences of arterial calcifications and soft-tissue calcifications in chronic kidney disease

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The arterial calcifications from an active process implicating the interaction of promoters and inhibitors of calcifications that are responsible for phenotype transdiferentiation of vascular smooth muscle cells into ostoblast-like osteogenic cells. This process is influenced by mechanical factors including pulsatile and shear stresses. The two types of calcifications, i.e. intimal and medial have a different impact on arterial functions. The intimal calcification as a part of advanced atherosclerosis results in the development of plaques, arterial lumen decrease or occlusion, and ischemic lesions downstream. Medial calcifications result in the stiffening of arterial walls with an increased systolic and decreased diastolic pressures. This leads to cardiac pressure overload, left ventricular hypertrophy and decreased myocardial perfusion. The two types of calcifications are associated with increased mortality.

Chapter.  5045 words.  Illustrated.

Subjects: Rheumatology ; Nephrology

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