›› 2010, Vol. 9 ›› Issue (5): 251-254.

• 临床研究 • Previous Articles     Next Articles

Effect of early intervention in calcium and phosphorus metabolism on vascular calcification in patients with chronic kidney disease

LUO Fu-zhang, DENG Jie-yao, HONG Guo-bao, CHEN Jian-zhi, LI Xuan, CAO Xiuhuai   

  1. 1Division of Nephrology; 2Pathology of the Affiliated Nan Hai Hospital of South Medical University, Foshan 528200, China
  • Received:2009-10-13 Revised:1900-01-01 Online:2010-05-12 Published:2010-05-12

Abstract:

【Abstract】 Objective To investigate the effects of early improving disorder of calcium and phosphorus metabolism on vascular calcification(VC) in stage 3 of chronic kidney disease (CKD). Methods 106 patients at stage 3, 4 and 5 of non-dialysis patients of CKD were divided into intervention group or control group randomly. Patients of intervention group were administered phosphate binding drugs or 1,25 dihydroxy vitamin D to ensure that their serum level calcium, intact phosphate or parathyroid hormone (iPTH) keep at the suitable extent of the K/DOQI guideline. The trial would be concluded if patients progressed to end-stage renal disease(ESRD)and needed hemodialysis or other replacement treatment. Segments of radial arteries were obtained during the operation of A-V fistula and observed by Alizarin red stain and immunohistochemical staining. Results 49 patients progressed to ESRD and needed replacement therapy finally. All subjects received A-V fistula operation in which some segments of radial arteries were obtained. Cases and severity of VC in intervention group were signi?cantly reduced compared with controls(P<0.05). Osteopontin (OPN)抯 level was significantly increased and -smooth muscle actin(-SMA)抯 level was significantly decreased in VS cases compared with controls. Conclusion The intervention of calcium and phosphorus metabolism disorder earlier can effectively ameliorate VS in stage 3 or 4 CKD patients. Changes of OPN and -SMA are earlier than definite calcification. VC was positively correlated to OPN, and was negatively correlated to -SMA. OPN and -SMA may be earlier markers of VC in CKD patients.

Key words: Phosphorus, Chronic kidney disease, End-stage renal disease, Bone metabolism disorder