The bone-vessel axis in chronic kidney disease: An update on biochemical players and its future role in laboratory medicine

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Pereira, L (Author) Other; João Frazão (Author) FMUP

Journal

Title: Clinica Chimica Acta

Vol. 508

Pages: 221-227

ISSN: 0009-8981

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 16 Citations

Scopus - 18 Citations

Other information

Authenticus ID: P-00S-5T7

DOI: 10.1016/j.cca.2020.05.023

Abstract (EN): Vascular wall calcification (VC) is highly prevalent in patients with chronic kidney disease (CKD). In CKD, VC is more frequent and severe than in the general population and it is associated with increased cardiovascular mortality and morbidity. In the last years, laboratory and clinical evidence have drawn the attention to the relationship between bone disease and VC in CKD patients, leading to the concept of a bone-vessel or bone-vascular axis. It means that disorders of bone volume and bone turnover may influence the risk of VC and ultimately the high risk of cardiovascular mortality. In fact, a higher burden of VC has been associated to low bone volume and low bone turnover in hemodialysis (HD) patients with renal osteodystrophy characterized by histomorphometric evaluation of bone biopsies. The molecular mechanisms underlying the regulation of bone cells and vascular cells in CKD are poorly understood. In this review, we discuss relevant evidence linking bone disorders and VC in CKD and also rising molecular players involved in this bone-vascular axis. Indeed, accumulating data is available for two proposed systems: receptor activator for nuclear factor kB (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) system and inhibitors of Wnt signaling - mainly sclerostin. Although they are promising biochemical markers linking bone formation and bone reabsorption with VC, there is a long way to go as long evidence from laboratory studies is often divergent to the clinical data as will be discussed. Future prospective studies are needed in order to evaluate the role of these biochemical players as useful clinical markers for VC, bone volume and perhaps bone turnover.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7