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Association of Serum Alkaline Phosphatase with Coronary Artery Calcification in Maintenance Hemodialysis Patients
Clinical Journal of the American Society of Nephrology, 06/05/09

Shantouf R et al. - An association between serum alkaline phosphatase level and CACS exists in MHD patients. Given the high burden of vascular calcification in patients with CKD, examining potential therapeutic interventions to modulate the alkaline phosphatase pathway may be warranted.

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Ronney Shantouf, 06/11/09

This study demonstrated an association between serum alkaline phosphatase levels and coronary artery calcium scores (CACS) in maintenance hemodialysis patients. Serum alkaline phosphatase levels of > 120 IU/L predicted elevated CACS in our study. A recent epidemiologic study showed that elevated levels of alkaline phosphatase were associated with an increased risk of death in maintenance hemodialysis patients. Furthermore in vitro studies have found a link between alkaline phosphatase and vascular calcification via modulation of the pyrophosphate pathway. This study provides a possible link between the epidemiologic data and the in vitro studies, opens the door for further research into the area, and raises the option for potential therapeutic strategies to modulate this pathway and potentially alter if not prevent vascular calcification in hemodialysis patients. More research including interventional trials are needed.

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