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Trigueira PDC, Leal VDO, Cardoso BR, Mafra D, Araujo MC, Stockler-Pinto MB. Selenium supplementation in chronic kidney disease patients undergoing haemodialysis: a systematic review of the effects on plasma selenium, antioxidant and inflammatory markers, immunological parameters and thyroid hormones. Nutr Res Rev 2024:1-12. [PMID: 39320843 DOI: 10.1017/s0954422424000222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024]
Abstract
Selenium (Se) is a mineral with several biological functions, and studies have shown that its deficiency can be linked to many complications in patients with chronic kidney disease (CKD). This study aims to systematically review the effects of Se supplementation in patients with CKD undergoing haemodialysis (HD). This systematic review was carried out according to the PRISMA statement. Clinical trials were searched in PubMed, Lilacs, Embase, Scopus and Cochrane Library databases from inception to July 2021 and updated in July 2024. The protocol was registered on PROSPERO (CRD42021231444). Two independent reviewers performed the study screening and data extraction, and the risk of bias was evaluated using the Cochrane Collaboration tool. Thirteen studies were included in this review. Only nine studies showed results on Se levels; in all, reduced Se levels were observed before supplementation. A positive effect of supplementation on plasma Se level was demonstrated. Of the ten studies analysed, six demonstrated positive effects on antioxidant and inflammatory markers. Only one study analysed immunological parameters, showing a positive impact. From two studies that analysed thyroid hormones, only one showed positive results. All studies were classified as high risk of bias. The findings suggest that Se supplementation significantly increases plasma Se levels in these patients; however, there are still not enough studies to clarify the effects of Se supplementation on the antioxidant and inflammatory markers, immune system and thyroid hormones. Further studies are needed to elucidate the effects of Se supplementation and to provide a recommendation for patients with CKD undergoing HD.
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Affiliation(s)
- Pricilla de C Trigueira
- Post-Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
- Post-Graduate Program in Pathology, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Viviane de O Leal
- Pedro Ernesto University Hospital (HUPE), University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Barbara R Cardoso
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
- Victorian Heart Institute, Monash University, Clayton, VIC, Australia
| | - Denise Mafra
- Post-Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
- Post-Graduate program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
- Post-Graduate Program in Biological Sciences-Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Marina C Araujo
- Sergio Arouca National School of Public Health-Oswaldo Cruz Foundation/Ministry of Health, Rio de Janeiro, RJ, Brazil
| | - Milena B Stockler-Pinto
- Post-Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
- Post-Graduate Program in Pathology, Fluminense Federal University (UFF), Niterói, RJ, Brazil
- Post-Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
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Lian Y, Li Y, Liu A, Ghosh S, Shi Y, Huang H. Dietary antioxidants and vascular calcification: From pharmacological mechanisms to challenges. Biomed Pharmacother 2023; 168:115693. [PMID: 37844356 DOI: 10.1016/j.biopha.2023.115693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/01/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023] Open
Abstract
Vascular calcification (VC), an actively regulated process, has been recognized as an independent and strong predictor of cardiovascular disease (CVD) and mortality worldwide. Diet has been shown to have a major role in the progression of VC. Oxidative stress (OS), a common pro-calcification factor, is closely related to VC, and evidence strongly suggests that dietary antioxidants directly prevent VC. Herein, we provided an overview of OS and its key role in VC and underlined the mechanisms of harmful effects of OS on VC. Furthermore, we introduced dietary antioxidants, and discussed about surrounding the challenges of dietary antioxidants in VC management. This review will benefit future research about the effects of dietary antioxidants on cardiovascular health.
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Affiliation(s)
- Yaxin Lian
- The Eighth Affiliated Hospital, Sun Yat-sen University, No. 3025, Shennan Middle Rd, Futian District, 518033 Shenzhen, China
| | - Yue Li
- The Eighth Affiliated Hospital, Sun Yat-sen University, No. 3025, Shennan Middle Rd, Futian District, 518033 Shenzhen, China
| | - Aiting Liu
- The Eighth Affiliated Hospital, Sun Yat-sen University, No. 3025, Shennan Middle Rd, Futian District, 518033 Shenzhen, China
| | - Sounak Ghosh
- Department of Internal Medicine, AMRI Hospital, Kolkata, India
| | - Yuncong Shi
- The Eighth Affiliated Hospital, Sun Yat-sen University, No. 3025, Shennan Middle Rd, Futian District, 518033 Shenzhen, China
| | - Hui Huang
- The Eighth Affiliated Hospital, Sun Yat-sen University, No. 3025, Shennan Middle Rd, Futian District, 518033 Shenzhen, China.
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Alsogair R, Altoub HA, Alsanad M, Alshukr M, AlObaid B, Al Sayyari A, Abdalla M. The Relationship Between C-Reactive Protein (CRP) Concentrations and Erythropoietin Resistance, Hospital Admission Rate, Control of Mineral Metabolism, and Comorbidity in Hemodialysis Patients. Cureus 2023; 15:e48793. [PMID: 38098917 PMCID: PMC10720688 DOI: 10.7759/cureus.48793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Background End-stage kidney disease patients undergoing hemodialysis are prone to develop inflammation detected by high serum C-reactive protein (CRP) levels. This study highlights the association between CRP and the erythropoietin resistance index, hospital admission rate, control of mineral metabolism, and comorbidities in a tertiary hospital and two dialysis centers in Saudi Arabia. Objectives The objective of the study is to assess the relationship between CRP levels and hemoglobin level, hospital admission rate, mineral metabolism, and comorbidity in hemodialysis patients. Materials and methods This was a cross-sectional study conducted at King Abdulaziz Medical City Dialysis Center and the South and North Dialysis Centers of King Abdullah Dialysis Program in Riyadh. All hemodialysis adult patients who have been on dialysis for over six months were included. Patients with acute illnesses and pediatric patients were excluded. The association between CRP and other variables was reported using the Pearson correlation test. The calculated sample size was 218 by using the Raosoft website; however, the final number we analyzed was 209 after exclusion. Results The prevalence of a high level of CRP was more common among patients with diabetes mellitus (p=0.008) and those who were using antihypertensives (p=0.044) while the prevalence of a high level of CRP was less common among underweight patients (p=0.031) and hepatitis C virus (HCV)-positive patients (p=<0.001). The mean value of Kt/V was significantly lower among patients with a high level of CRP (p=0.009). HCV negative was the only independent significant risk factor associated with high CRP concentration (p=0.006). Conclusions In conclusion, there was an association between CRP levels with BMI, diabetics, the use of antihypertensive medications, and negative or undetectable HCV test results with the latter being the only independent significant factor. These data suggest that patients meeting these characteristics are in an inflammatory state and more prone to develop complications; thus, implementing CPR testing in this population might be useful. Other reviews showing causations are needed to further elucidate.
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Affiliation(s)
- Reema Alsogair
- Medicine and Surgery, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Haifa A Altoub
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Meznah Alsanad
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Malak Alshukr
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Bashayer AlObaid
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdulla Al Sayyari
- Rheumatology, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Castro-Barquero S, Arias-Guillén M, Pi-Oriol S, Sacanella E, Romano-Andrioni B, Vidal-Lletjós S, Ruiz-León AM, Estruch R, Casas R. A Comparative Study of the Efficacy of an Intervention with a Nutritional Supplement for Patients with Chronic Kidney Disease: A Randomized Trial. J Clin Med 2022; 11:jcm11061647. [PMID: 35329972 PMCID: PMC8951226 DOI: 10.3390/jcm11061647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic kidney disease (CKD) involves heterogeneous diseases that affect the renal structure and function. Malnutrition plays a crucial role during patients with CKD on hemodialysis (HD) treatment and is associated with an increased rate and duration of hospitalizations. The aim of this randomized, parallel, intervention-controlled trial was to assess whether the use of daily supplementation with a new nutritional product developed by the Grand Fontaine Laboratories improves the nutritional status and anthropometric parameters of stage 5 CKD patients, compared with standard renal dietary advice, after three months of follow-up. Dietary intake, anthropometric measurements, physical activity, and blood samples were collected at baseline and after three months of intervention. Significant improvements were observed within the intervention group in body weight (1.5 kg [95% CI: 0.9 to 2.12 kg]) and BMI (0.54 kg/m2 [95% CI: 0.31 to 0.77]; p-value between groups, 0.002 and 0.006, respectively). In the control group, significant decreases were observed in transferrin saturation (-5.04% [95% CI: -8.88 to -1.21]) and alpha-tocopherol levels (-3.31 umol/L [95% CI: -6.30 to -0.32]). We concluded that daily dietary intake of a specific renal nutritional complement in CKD patients with or at risk of malnutrition may prevent deterioration in nutritional parameters.
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Affiliation(s)
- Sara Castro-Barquero
- Department of Medicine, Faculty of Medicine and Life Sciences, University of Barcelona, 08036 Barcelona, Spain; (S.C.-B.); (S.P.-O.); (E.S.); (R.E.)
- Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain;
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Marta Arias-Guillén
- Department of Nephrology, Hospital Clínic Barcelona, 08036 Barcelona, Spain;
| | - Sofia Pi-Oriol
- Department of Medicine, Faculty of Medicine and Life Sciences, University of Barcelona, 08036 Barcelona, Spain; (S.C.-B.); (S.P.-O.); (E.S.); (R.E.)
| | - Emilio Sacanella
- Department of Medicine, Faculty of Medicine and Life Sciences, University of Barcelona, 08036 Barcelona, Spain; (S.C.-B.); (S.P.-O.); (E.S.); (R.E.)
- Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain;
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
| | | | | | - Ana María Ruiz-León
- Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain;
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Mediterranean Diet Foundation, 08021 Barcelona, Spain
| | - Ramon Estruch
- Department of Medicine, Faculty of Medicine and Life Sciences, University of Barcelona, 08036 Barcelona, Spain; (S.C.-B.); (S.P.-O.); (E.S.); (R.E.)
- Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain;
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Rosa Casas
- Department of Medicine, Faculty of Medicine and Life Sciences, University of Barcelona, 08036 Barcelona, Spain; (S.C.-B.); (S.P.-O.); (E.S.); (R.E.)
- Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain;
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-93-2275745; Fax: +34-93-2275758
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Barroso CF, Pires LV, Santos LB, Henriques GS, Pessoa PP, de Araújo GN, de Araújo COD, Oliveira CMC, Maia CSC. Selenium Nutritional Status and Glutathione Peroxidase Activity and Its Relationship with Hemodialysis Time in Individuals Living in a Brazilian Region with Selenium-Rich Soil. Biol Trace Elem Res 2021; 199:2535-2542. [PMID: 32959338 DOI: 10.1007/s12011-020-02388-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 09/10/2020] [Indexed: 01/25/2023]
Abstract
Suboptimal selenium status may impair the antioxidant defense system in patients undergoing hemodialysis, compromising the selenoenzyme glutathione peroxidase activity. To evaluate the association between the duration of hemodialysis, nutritional selenium status, glutathione peroxidase activity (GPx), and thiobarbituric acid reactive substance (TBARS) levels in patients with chronic renal failure undergoing hemodialysis in a region of selenium-rich soils (Ceará, Northeast Brazil). The case-control study of 75 individuals aged 18 to 88 years was allocated between two groups: hemodialysis (n = 41) and control (n = 34). Plasma and erythrocytes selenium levels were determined by inductively coupled plasma optical emission spectrometry. The GPx activity and TBARS levels were also evaluated. In addition, the hemodialysis group was stratified according to the duration of treatment (≤ 59 months and ≥ 60 months). The Mann-Whitney test, Student's t test, and Pearson's or Spearman's correlation were applied according to the data distribution. Moreover, a quantile regression was performed. The significance level (p) was < 0.05. The hemodialysis group had lower selenium levels in their plasma and erythrocytes than the control group (p < 0.001). However, there was no difference in the GPx activity between the groups. Furthermore, an association between the hemodialysis group and selenium levels in plasma (coefficient - 16,343, p < 0.001) and erythrocytes (coefficient - 7839, p = 0.003) was observed by quantile regression, independent of age, sex, and body-mass index. In individuals who had undergone treatment for 60 months or more, GPx activity was lower (p = 0.026) and TBARS levels higher (p = 0.011) than in those who had undergone treatment for less than 60 months. The status of selenium was reduced in the hemodialysis group compared to the control group. The lower GPx activity and higher levels of TBARS in individuals who had undergone treatment for 60 months or more correlated with greater oxidative stress.
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Affiliation(s)
- Christielle Félix Barroso
- Nutrition and Health Post-Graduation Program, State University of Ceará (UECE), Av. Dr. Silas Munguba, 1700, CCS Directory Square, Itaperi Campus, Fortaleza, CE, 60740-000, Brazil
| | - Liliane Viana Pires
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Federal University of Sergipe, São Cristovão, Sergipe, Brazil
| | - Larissa Bezerra Santos
- Micronutrients and Chronic Diseases Research Group, Stare University of Ceará, Fortaleza, Brazil
| | | | - Priscila Pereira Pessoa
- Nutrition and Health Post-Graduation Program, State University of Ceará (UECE), Av. Dr. Silas Munguba, 1700, CCS Directory Square, Itaperi Campus, Fortaleza, CE, 60740-000, Brazil
| | | | - Camilla Oliveira Duarte de Araújo
- Nutrition and Health Post-Graduation Program, State University of Ceará (UECE), Av. Dr. Silas Munguba, 1700, CCS Directory Square, Itaperi Campus, Fortaleza, CE, 60740-000, Brazil
| | - Cláudia Maria Costa Oliveira
- HUWC Renal Transplant Unit - Federal University of Ceará and Fortaleza General Hospital, Fortaleza, Ceará, Brazil
| | - Carla Soraya Costa Maia
- Nutrition and Health Post-Graduation Program, State University of Ceará (UECE), Av. Dr. Silas Munguba, 1700, CCS Directory Square, Itaperi Campus, Fortaleza, CE, 60740-000, Brazil.
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Liu Y, Wang L, Li S, Xu S, Zhou D, Zhong X, Tan R, Liu Y. Associations Between Blood Trace Element Levels and Nutritional Status in Maintenance Hemodialysis. J Ren Nutr 2021; 31:661-668. [PMID: 33941438 DOI: 10.1053/j.jrn.2020.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE(S) We aimed to investigate the associations between blood trace element levels and nutritional status in patients undergoing maintenance hemodialysis (MHD). METHODS This cross-sectional study included patients undergoing MHD who were treated at our center in September 2019. Clinical and demographic data and blood samples were collected before hemodialysis sessions, and the levels of manganese, lead, selenium, zinc, and copper were measured by inductively coupled plasma mass spectrometry. The Simplified Nutritional Appetite Questionnaire scale was used to assess patient appetite. Skinfold thickness, bicep circumference, upper arm muscle circumference, 7-point Subjective Global Assessment, Nutritional Risk Screening 2002 (NRS 2002), and Geriatric Nutritional Risk Index (GNRI) were used to assess patient nutritional status. Univariate and multivariate logistic regression analyses were performed to study the relationship between trace elements and nutritional indicators. RESULTS In total, 118 patients (64 males and 54 females) were included, with a median dialysis vintage of 34.0 months (16.0-54.5 months) and an average age of 63.20 ± 14.26 years. Malnourished patients, as defined by the GNRI, Subjective Global Assessment, and NRS 2002, accounted for 28.0%, 49.2%, and 26.3% of enrolled patients, respectively. The multivariate binary logistic regression showed that higher blood copper levels were independently associated with nutritional risk defined as GNRI ≤91.2 (odds ratio [OR] = 1.003, 95% confidence interval [CI] = 1.000-1.006; P = .020), whereas lower blood zinc levels (OR = 0.634, 95% CI = 0.439-0.916; P = .015), blood zinc < 4.220 mg/L (OR = 3.723, 95% CI = 1.274-10.879; P = .016), lower blood selenium levels (OR = 0.959, 95% CI = 0.929-0.990; P = .010), and blood selenium < 85 μg/L (OR = 5.568, 95% CI = 1.039-29.840; P = .045) were independently associated with a nutritional risk defined as NRS 2002 ≥ 3. CONCLUSION(S) Higher levels of blood copper and lower levels of blood zinc and selenium were independently associated with higher nutritional risk in MHD patients.
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Affiliation(s)
- Yun Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China; Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China.
| | - Liangtao Wang
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Shuting Li
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Shilin Xu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Daoyuan Zhou
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Xiaoshi Zhong
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Rongshao Tan
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China; Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Yan Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China; Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, China
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Zununi Vahed S, Mostafavi S, Hosseiniyan Khatibi SM, Shoja MM, Ardalan M. Vascular Calcification: An Important Understanding in Nephrology. Vasc Health Risk Manag 2020; 16:167-180. [PMID: 32494148 PMCID: PMC7229867 DOI: 10.2147/vhrm.s242685] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/17/2020] [Indexed: 12/11/2022] Open
Abstract
Vascular calcification (VC) is a life-threatening state in chronic kidney disease (CKD). High cardiovascular mortality and morbidity of CKD cases may root from medial VC promoted by hyperphosphatemia. Vascular calcification is an active, highly regulated, and complex biological process that is mediated by genetics, epigenetics, dysregulated form of matrix mineral metabolism, hormones, and the activation of cellular signaling pathways. Moreover, gut microbiome as a source of uremic toxins (eg, phosphate, advanced glycation end products and indoxyl-sulfate) can be regarded as a potential contributor to VC in CKD. Here, an update on different cellular and molecular processes involved in VC in CKD is discussed to elucidate the probable therapeutic pathways in the future.
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Affiliation(s)
| | - Soroush Mostafavi
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammadali M Shoja
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
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