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Chronic Kidney Disease PowerPoint Presentation

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Description : fetuin A is marker for CAC score in CKD

Tags : omnia,chronic kidney disease,kidney disease,kidney,chronic kidney,fetuin A

Published on : Nov 19, 2022 | Views : 1997 | Downloads : 8

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Chronic kidney disease (CKD) is a worldwide health problem, with increased risk for morbidity and death. It is considered as an important risk factor for cardiovascular disease. The cardiovascular death rate in CKD patients is at least 10 times higher when compared with normal population. Despite renal transplant recipients (RTRs) have improved survival, they remain at an increased risk for CVD.
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One of most important risk factor for morbidity in CKD patients is extraosseous calcification which means calcification of tissues and organs outside bone and teeth. CKD patients have increased incidence of cardiovascular calcification. It has been reported that both vascular calcifications (VC) and soft tissues calcification often occurred at the same time, and could be detected in 80% of dialysis patients
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VC is one of the most important predictors of cardiovascular risk in CKD patients. ▪ The risk factors that suggested to predispose patients with CKD to VC include: A. Traditional Risk factors: 1- Older age. 2- Diabetes mellitus. 3- Dyslipidemia. 4- Inflammation. B. Uremia-related Risk factors: 1- Hyperphosphatemia. 2- Uremic toxins. 3- Calcium containing phosphate binders. 4- Vitamin D therapy. 5- Decrease inhibitor of VC such as fetuin-A.
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CKD patients with VC have two different but overlapping arterial pathologies: atherosclerosis and arteriosclerosis. Atherosclerosis is primarily an intimal disease, with patchy plaques that spread and occur in medium-sized arteries. Arteriosclerosis is calcification of the media layer, which usually occurs along the elastic lamina that may lead to increased arterial stiffness.
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Fetuin-A is a glycoprotein synthesized by hepatocytes. It also named α2-HS-glycoprotein or α2- Heremans-Schmid glycoprotein (AHSG) in honor of its two original discoverers Fetuin-B was discovered as a second member of the fetuin family, so the “original” fetuin was given another name as fetuin-A
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The two fetuins have similar domains and molecular weight (MW), but they have different function as they exhibit significance difference at the amino acid sequence level. Fetuin-A act as calcification inhibitor this explain that fetuin-A-deficient mice have ectopic calcification. On other hand fetuin-B help oocyte maturation so fetuin-B-deficient female mice are infertile.
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Fetuin-A is a multifunctional plasma protein: 1- Inhibits extraosseus calcification. 2- Inhibits insulin receptor tyrosine kinase leading to insulin resistance and increasing risk for type 2 diabetes and metabolic syndrome (MetS). 3- Reduces the expression of the atheroprotective adipokine-adiponectin and deterioration of free fatty acid uptake and storage in adipocytes.
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Higher levels of fetuin-A may be associated with: Fat accumulation in the liver. MetS. Atherogenic lipid profile. On the other hand low levels of fetuin-A are associated with inflammation as it is a negative acute phase reactant resulting in vascular calcifications.
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