Phosphate, Calcification in Blood, and Mineral Stress: The Physiologic Blood Mineral Buffering System and Its Association with Cardiovascular Risk

International Journal of Nephrology
Andreas PaschEdward R Smith

Abstract

Phosphate is an important cardiovascular risk factor and lowering elevated blood phosphate concentrations is a main therapeutic target in kidney patients. Phosphate is subject to the blood mineral buffering system which controls the precipitation of calcium and phosphate. Calciprotein particles (CPP), self-assembling complexes of calcium phosphate and serum proteins, are the nanomorphological correlates of this system. CPP1 are spherical, 50-100 nm in diameter, and contain amorphous mineral. CPP2 are oblongated, 100-200nm in the long axis, and they contain a crystalline mineral core. The relative abundance and biological activity of these particles are a matter of intense research, because they can cause oxidative stress, inflammation, and calcification in cellular assay. Therapeutically reducing this endogenous stressor by prolonging crystal formation time might improve patient outcome. This concise review article summarizes our current knowledge about the blood mineral buffering system and proposes Mineral Stress as a novel modifiable cardiovascular risk factor. It furthermore outlines possible implications this might have for improving patient care.

References

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Citations

Apr 16, 2019·Current Opinion in Nephrology and Hypertension·Jakob VoelklIoana Alesutan
Jun 25, 2019·British Journal of Pharmacology·Mariela CastelblancoNathalie Busso
Nov 26, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Iain BressendorffEdward R Smith
May 15, 2020·Current Opinion in Nephrology and Hypertension·Edward R SmithWilli Jahnen-Dechent
Jul 28, 2019·Cellular and Molecular Life Sciences : CMLS·Edward R SmithTim D Hewitson
Aug 26, 2020·Journal of Biological Inorganic Chemistry : JBIC : a Publication of the Society of Biological Inorganic Chemistry·Hong-Xing FanTian-Lan Zhang
Mar 20, 2019·Cellular and Molecular Life Sciences : CMLS·Jakob VoelklIoana Alesutan
Dec 30, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Anique D Ter BraakeJoost G J Hoenderop
Jan 9, 2021·Clinical Science·Jakob VoelklCarsten A Wagner
Feb 26, 2021·BMJ Open Diabetes Research & Care·Rik MenckePeter R van Dijk

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Methods Mentioned

BETA
biopsies

Clinical Trials Mentioned

NCT03292029
NCT03565913
NCT03301558
NCT02915601
NCT03010072
NCT02542319
NCT02977117
NCT02621762
NCT03104166
NCT03493087

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