Vascular calcification: When should we interfere in chronic kidney disease patients and how?

doi:10.5527/wjn.v5.i5.398

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Nephrol. Sep 6, 2016; 5(5): 398-417
Published online Sep 6, 2016. doi: 10.5527/wjn.v5.i5.398

Vascular calcification: When should we interfere in chronic kidney disease patients and how?

Usama Abdel Azim Sharaf El Din, Mona Mansour Salem, Dina Ossama Abdulazim

Usama Abdel Azim Sharaf El Din, Department of Nephrology, School of Medicine, Cairo University, Cairo 11759, Egypt

Mona Mansour Salem, Department of Endocrinology, School of Medicine, Cairo University, Cairo 11759, Egypt

Dina Ossama Abdulazim, Department of Rheumatology and Rehabilitation, School of Medicine, Cairo University, Cairo 11759, Egypt

Author contributions: El Din UAAS and Salem MM performed the majority of writing the manuscript; Abdulazim DO collected the references and highlighted the points of relevance in each article and revised the manuscript after being prepared.

Conflict-of-interest statement: Authors declare no conflict of interests for this article.

Correspondence to: Usama Abdel Azim Sharaf El Din, MD, Professor, Department of Nephrology, School of Medicine, Cairo University, 58^th Abbas El Akkad St., Nasr City, Cairo 11759, Egypt. usamaaas@gmail.com

Telephone: +20-11-11333800 Fax: +20-22-22753890

Received: March 17, 2016
Peer-review started: March 19, 2016
First decision: April 19, 2016
Revised: April 20, 2016
Accepted: June 27, 2016
Article in press: June 29, 2016
Published online: September 6, 2016
Processing time: 168 Days and 12.4 Hours

Core Tip

Core tip: The last 2 decades witnessed the failure of all intervention studies targeting different risk factors of vascular calcification in chronic kidney disease (CKD) patients on regular hemodialysis. The main aim of all these studies was to decrease cardiovascular morbidity and mortality among such patients. These disappointing results criticized the value of such interventions in clinical practice. On the other hand, when similar trials were run on patients at an earlier stage of CKD, most of these trials showed a significant impact on patient survival and/or cardiovascular morbidity. Such discrepancy indicates the value of timing of interference. We are trying in this review to develop the ideal strategy that would optimize the management of CKD patients to avoid the devastating vascular calcification, highlighting the value of different medicines used in this plan. Meanwhile we are showing the update in guidelines concerned with this issue.