Phosphorus and calcium metabolism and the cardiovascular system in patients with early-stage chronic renal disease

Abstract

Aim. To define the impact of phosphorus and calcium metabolic disturbances in patients with early-stage chronic renal disease (CRD) on the cardiovascular system. Subects and methods. The levels of phosphate (P), calcium, parathyroid hormone (PTH), 25(OH) vitamin D and 1,25(OH)2 vitamin D, serum lipidogram, carotid artery intima-media thickness (IMT), and X-ray degree of abdominal artery calcification (AAC) were determined and echocardiography, electrocardiography and blood pressure monitoring were made in 465 patients with Stages I-V CRD who did not receive renal replacement therapy (of them, 73.5% of the patients had early (I to III) stages). Results. Blood 1,25(OH)2D was related inversely to left ventricular (LV) posterior wall thickness, blood pressure (BP), triglycerides, and the degree of AAC and correlated directly to the severity of LV diastolic dysfunction and inversely to IMT, the presence of coronary heart disease and heart failure (HF). ACC, LV hypertrophy, and arterial hypertension (AH) were more significant in patients with higher serum levels PTH and P. Conclusion. In patients with early-stage CRD, phosphorus and calcium metabolic disturbances promote the development of AH, vascular and cardiac valvular calcification, myocardial hypertrophy, and HF.

Keywords

• 25(oh)-vitamin d
• 1,25(oh)2-vitamin d
• parathyroid hormone
• phosphate
• heart failure
• cardiac valvular calcification
• abdominal aortic calcification
• arterial hypertension