Kidney News January 2012, 4#1 : Page 1
January 2012 | Vol. 4, Number 1 The Calcium Paradox Revisited By Julie Taylor a greatly increased risk of cardiovascu-lar death. The mechanisms involved in the accelerated vascular calcifica-tion observed in CKD have recently become more clear, leading to the hypothesis that perhaps a lack of natural inhibitors of calcification may trigger calcium deposi-tion. Aging can be seen as a process of cal-cification, the lit-eral ossification of the body’s tis-sues—includ-ing the arteries, heart, kidney, and brain—while at the same time calcium is lost from bone, resulting in thinning and fracturing of the bones, or osteoporosis. Osteoporosis results when the body removes more bone than it replaces. Calcification outside the bone tissue is due to the body’s regulators of calcium metabolism becoming less efficient as aging progresses. A recent study looked at the pro-gression of aortic calcification in chronic dialysis patients with disor-ders of mineral metabolism ( Nephrol Dial Transplant 2011; 5:1747–8). “Aortic calcification progressed in almost a third of the patients during dialysis,” said Marlies Noordzil of the department of clinical epidemiology at the University of Amsterdam. “Hy-percalcemia and hyperparathyroidism were associated with an increased risk of progression.” It’s well known that Vitamin D3 and vitamin K-complex, as well as magnesium, help normalize the effi-ciency of calcium metabolism ensur-ing proper calcification of bone tissue while preventing pathological calcifi-cation of the vascular and organ sys-tems. These vitamins work synergisti-cally to keep calcium where it belongs. Much has been written about vita-min D recently and the “monitoring and maintenance of vitamin levels throughout the stages of CKD” said Eleanor Lederer, professor of medi-Continued on page 3 Inside 5 Nanotechnology, pediatric transplant disparities, gene therapy, measuring quality and comparing effectiveness all made our “top to watch in 2012” list. The List 13 Journal View R ecent findings may help explain the calcium paradox— the relationship between os-teoporosis and atherosclerosis—that plays a large role in aging and is a par-ticular concern in those with chronic kidney disease (CKD). Patients with CKD have a higher incidence of vascular calcification and Can elevated levels of in ammation markers predict long-term risk of chronic kidney disease (CKD)? 14 Policy Update CDC initiates electronic death certi cate; ASN provides input 16 Up in Space Hepatitis C Infection with HIV Raises Risk of Chronic Kidney Disease C hronic hepatitis C virus (HCV) infection raises the risk for chron-ic kidney disease (CKD) in people infected with human immunode ciency virus (HIV). Clearing the HCV infection appears to reverse this e ect, researchers have found. “In this whole era of treatability of HIV [and] the aging patient, it becomes of much bigger concern what other target organ damage are we going to see,” Jürgen Rockstroh, MD, told ASN Kidney News at the 13th European AIDS Conference in Belgrade, Serbia, late last year. Rockstroh is professor of medicine and head of the HIV clinic in the department of medicine at the University of Bonn in Bonn, Germany. “In several observations we’ve seen there has been an independent association between hepatitis C co-infection and risk for development of chronic kidney dis-ease,” Rockstroh said. In the United States, about 25 percent of individuals infected with HIV are also infected with HCV. e rate among injec-tion drug users is much higher. About 80 percent of users with HIV are also infected with HCV, according to the U.S. Centers for Disease Control and Prevention. Using the prospective, observational Continued on page 3 And down to earth again. ASN Past President Joseph V. Bonventre interviews space expert Jonathan B. Clark about the health effects of space and lessons for medicine on earth. 18 Detective Nephron Hypomagnesemia and proton pump inhibitors
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