Mineral-bone disorders in patients with chronic kidney disease and diabetes mellitus: the real possibilities of cardio and nephroprotection.
https://doi.org/10.21518/2079-701X-2018-4-60-65
Abstract
Secondary hyperparathyroidism (SHPT) is a disabling complication of chronic kidney disease (CKD), which is characterized by a significant increase in the rate of metabolic processes in bone tissue, leading to a disruption in its structure and an increased risk of fractures, as well as cardiovascular pathology. Vitamin D deficiency, which is the main pathogenetic link in the development of mineral-bone disorders (MBD), contributes to a decrease in insulin secretion, insulin resistance, and pancreatic β-cell defect. Due to the effects on carbohydrate and lipid metabolism, renin-angiotensin-aldosterone system (RAAS), and also participation in oxidative stress, vitamin D is considered today as an integral part of the treatment of cardiorenal syndrome, the concept of which is based on the existence of mutually affecting various pathogenetic factors that adversely affect in relation to the heart and kidneys. A meta-analysis of observational studies has shown that a high concentration of vitamin D in the blood serum is associated with a 43% reduction in cardiometabolic disorders in patients with diabetes mellitus (DM), CKD and SHPT, compared to low concentrations. Perspective drugs for correction of phosphoric-calcium metabolism, improvement of renal function and reduction of cardiovascular risks in this cohort of patients include paricalcitol.
About the Authors
N. G. Mokrysheva
National Medical Research Center of Endocrinology of the Ministry of Health of Russia
Russian Federation
Russian Federation
I. S. Maganeva
National Medical Research Center of Endocrinology of the Ministry of Health of Russia
Russian Federation
MD, Prof.
Russian Federation
MD, Prof.
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Review
For citations:
Mokrysheva NG, Maganeva IS. Mineral-bone disorders in patients with chronic kidney disease and diabetes mellitus: the real possibilities of cardio and nephroprotection. Meditsinskiy sovet = Medical Council. 2018;(4):60-65. (In Russ.) https://doi.org/10.21518/2079-701X-2018-4-60-65
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