Mineral metabolism abnormalities and vitamin D rec

Authors: Claudio Ronco Mario Cozzolino

Publish Date: 2011/02/13

Volume: 17, Issue: 2, Pages: 211-220

PDF Link

Abstract

Over the last decade it has become increasingly clear that the cardiovascular and renal systems are interdependent Primary disorders of either system have been shown to disturb the other system As a result a class of cardiorenal syndromes CRS has been identified wherein a vicious cycle is established as an acute/chronic dysfunction of either the kidney or the heart exacerbates the loss of function in the other organ Progressive loss of kidney function observed in patients with CRS mostly types 2 and 4 leads to reduced production of calcitriol active vitamin D and an imbalance in calcium and phosphorus levels which are correlated with increased rates of cardiovascular events and mortality In addition hypocalcemia can lead to prolonged and excessive secretion of parathyroid hormone PTH eventually leading to development of secondary hyperparathyroidism Therefore based on this important mechanism of organ damage one of the major goals of therapy for patients with CRS is to restore regulatory control of PTH Although administration of calcitriol increases serum calcium levels and reduces PTH levels it is also associated with elevated serum levels of calcium–phosphorus product Therefore compounds that selectively activate vitamin D receptors potentially reducing calcium × phosphate toxicity are likely to enhance cardiorenal protection and provide significant clinical benefit

Keywords: