低镁血症加重慢性肾脏病患者心血管钙化的病理机制

    Pathological mechanisms of hypomagnesemia aggravating cardiovascular calcification in patients with chronic kidney disease

    • 摘要: 心血管死亡为慢性肾脏病患者的首要死亡原因,心血管钙化是心血管死亡的独立预测因素。最近的研究表明,低镁血症与慢性肾脏病患者心血管死亡和全因死亡率增加有关,低镁可能会促进心血管钙化的发生发展。动物试验和体外研究提示,低镁血症通过被动途径降低血磷并延缓羟基磷灰石结晶的生成,通过主动途径参与血管平滑肌细胞的成骨转化。临床研究和动物试验提示膳食补镁可减轻慢性肾脏病患者的血管钙化并降低全因死亡率。因此,理解血清镁参与心血管钙化的病理机制对于改善慢性肾脏病患者预后、指导临床用药方面是有必要的。本文将对低镁血症加重慢性肾脏病患者心血管钙化的病理机制进行综述。

       

      Abstract: Cardiovascular death is the leading cause of mortality in patients with chronic kidney disease(CKD) and cardiovascular calcification is an independent predictor of cardiovascular death.Recent studies have shown that hypomagnesemia is associated with severe cardiovascular death and all-cause mortality in CKD patients.Besides,it can promote the development of cardiovascular calcification.Animal experiments and in vitro studies revealed that hypomagnesemia reduced blood phosphorus and arrested the formation of hydroxyapatite crystals through a passive pathway and participated in osteogenic transformation of vascular smooth muscle cells through an active way.Clinical trials and animal experiments indicated that dietary magnesium supplementation reduced vascular calcification and lowered all-cause mortality.Therefore,it is necessary to understand the pathological mechanism of serum magnesium in cardiovascular calcification for improving the prognosis of CKD patients and guiding clinical medication.This review summarized the pathological mechanisms of hypomagnesemia aggravating cardiovascular calcification in CKD patients.

       

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