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Vascular Calcification and Calciphylaxis in Peritoneal Dialysis Patients

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Nolph and Gokal's Textbook of Peritoneal Dialysis

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Abstract

Cardiovascular disease is the leading cause of death in end-stage renal disease (ESRD) patients, including hemodialysis and peritoneal dialysis (PD). Nearly half of the PD patient population dies from cardiovascular disease and many more have debilitating consequences associated with it, including stroke, limb amputation and chronic pain. Vascular calcification, a phenomenon closely related to the development of cardiovascular disease is prevalent in patients with chronic kidney disease (CKD).

Vascular calcification is not a single disease, but rather a manifestation of multiple complex pathologic pathways, it is commonly divided into 2 different types based on the histologic location of the calcium deposits within the arteries walls: Intimal vascular calcification, and medial vascular calcification. Intimal calcium deposition is associated with atherosclerosis, the leading cause of coronary artery disease in patients with and without CKD. Medial calcium deposition disproportionately affects patients with CKD and results in arterial stiffness and ventricular dysfunction. A third form of ectopic calcification: Calciphylaxis, will also be reviewed here. In Calciphylaxis there is medial calcium deposition and microthrombi formation in the lumen of arterioles of the dermis and subcutaneous tissues, which leads to ischemia of these affected tissues and produces a devastating clinical disease. Recent insights into the molecular pathways associated with ectopic calcification and the knowledge gained from various forms of arterial calcification associated with genetic variations will likely in the near future, lead to the identification of patients at higher risk for vascular calcification and to the development of more effective treatments and prevention strategies.

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References

  1. Mizobuchi M, Towler D, Slatopolsky E. Vascular calcification: the killer of patients with chronic kidney disease. J Am Soc Nephrol. 2009;20:1453–64.

    Article  CAS  PubMed  Google Scholar 

  2. Wang AY. Vascular and valvular calcification in chronic peritoneal dialysis patients. Int J Nephrol. 2011;2011:198045.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Raggi P, Boulay A, Chasan-Taber S, et al. Cardiac calcification in adult hemodialysis patients: a link between end-stage renal disease and cardiovascular disease? J Am Coll Cardiol. 2002;39:695–701.

    Article  PubMed  Google Scholar 

  4. Vervloet M, Cozzolino M. Vascular calcification in chronic kidney disease: different bricks in the wall? Kidney Int. 2017;91:808–17.

    Article  PubMed  Google Scholar 

  5. Yilmaz M, Matsubara K, Stenvinkel P, Lindholm B, Mehrotra R. Vascular calcification in chronic kidney disease. In: Anonymous Nolph and Gokal’s textbook of peritoneal Dialysis: Springer, Boston, MA; 2009. p. 697–711.

    Google Scholar 

  6. Voelkl J, Cejka D, Alesutan I. An overview of the mechanisms in vascular calcification during chronic kidney disease. Curr Opin Nephrol Hypertens. 2019;28:289–96.

    Article  CAS  PubMed  Google Scholar 

  7. Jablonski KL, Chonchol M. Vascular calcification in end-stage renal disease. Hemodial Int. 2013;17:S17–21.

    Article  PubMed  Google Scholar 

  8. Nigwekar SU, Thadhani R, Brandenburg VM. Calciphylaxis. N Engl J Med. 2018;378:1704–14.

    Article  CAS  PubMed  Google Scholar 

  9. Brandenburg VM, Schuh A, Kramann R. Valvular calcification in chronic kidney disease. Adv Chronic Kidney Dis. 2019;26:464–71.

    Article  PubMed  Google Scholar 

  10. Rostand SG, Sanders C, Kirk KA, Rutsky EA, Fraser RG. Myocardial calcification and cardiac dysfunction in chronic renal failure. Am J Med. 1988;85:651–7.

    Article  CAS  PubMed  Google Scholar 

  11. Goodman WG, Goldin J, Kuizon BD, et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med. 2000;342:1478–83.

    Article  CAS  PubMed  Google Scholar 

  12. Meema HE, Oreopoulos DG. Morphology, progression, and regression of arterial and periarterial calcifications in patients with end-stage renal disease. Radiology. 1986;158:671–7.

    Article  CAS  PubMed  Google Scholar 

  13. Merjanian R, Budoff M, Adler S, Berman N, Mehrotra R. Coronary artery, aortic wall, and valvular calcification in nondialyzed individuals with type 2 diabetes and renal disease. Kidney Int. 2003;64:263–71.

    Article  PubMed  Google Scholar 

  14. Leopold JA. Vascular calcification: mechanisms of vascular smooth muscle cell calcification. Trends Cardiovasc Med. 2015;25:267–74.

    Article  CAS  PubMed  Google Scholar 

  15. Chen NX, Moe SM. Vascular calcification: pathophysiology and risk factors. Curr Hypertens Rep. 2012;14:228–37.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Lanzer P, Boehm M, Sorribas V, et al. Medial vascular calcification revisited: review and perspectives. Eur Heart J. 2014;35:1515–25.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wang X, Zhang J, Xu X, Wu Y. Prevalence of coronary artery calcification and its association with mortality, cardiovascular events in patients with chronic kidney disease: a systematic review and meta-analysis. Ren Fail. 2019;41:244–56.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ramirez-Sandoval JC, Casanova I, Villar A, Gomez FE, Cruz C, Correa-Rotter R. Biomarkers associated with vascular calcification in peritoneal dialysis. Perit Dial Int. 2016;36:262–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Mönckeberg J. Über die reine Mediaverkalkung der Extremitätenarterien und ihr Verhalten zur Arteriosklerose. Virchows Arch Pathol Anat Physiol Klin Med. 1903;171:141–67.

    Article  Google Scholar 

  20. Selye H, Gentile G, Prioreschi P. Cutaneous molt induced by calciphylaxis in the rat. Science. 1961;134:1876–7.

    Article  CAS  PubMed  Google Scholar 

  21. Abedin M, Tintut Y, Demer LL. Vascular calcification: mechanisms and clinical ramifications. Arterioscler Thromb Vasc Biol. 2004;24:1161–70.

    Article  CAS  PubMed  Google Scholar 

  22. Albanese I, Khan K, Barratt B, Al-Kindi H, Schwertani A. Atherosclerotic calcification: Wnt is the hint. J Am Heart Assoc. 2018;7:e007356.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Johnson RC, Leopold JA, Loscalzo J. Vascular calcification: pathobiological mechanisms and clinical implications. Circ Res. 2006;99:1044–59.

    Article  CAS  PubMed  Google Scholar 

  24. Demer LL, Tintut Y. Vascular calcification: pathobiology of a multifaceted disease. Circulation. 2008;117:2938–48.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Cozzolino M, Fusaro M, Ciceri P, Gasperoni L, Cianciolo G. The role of Vitamin K in vascular calcification. Adv Chronic Kidney Dis. 2019;26:437–44.

    Article  PubMed  Google Scholar 

  26. Cozzolino M, Mangano M, Galassi A, Ciceri P, Messa P, Nigwekar S. Vitamin K in chronic kidney disease. Nutrients. 2019;11:168.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Westenfeld R, Jahnen-Dechent W, Ketteler M. Vascular calcification and fetuin-A deficiency in chronic kidney disease. Trends Cardiovasc Med. 2007;17:124–8.

    Article  CAS  PubMed  Google Scholar 

  28. Smith ER, Hewitson TD, Holt SG. Diagnostic tests for vascular calcification. Adv Chronic Kidney Dis. 2019;26:445–63.

    Article  PubMed  Google Scholar 

  29. Smith ER, Ford ML, Tomlinson LA, et al. Serum calcification propensity predicts all-cause mortality in predialysis CKD. J Am Soc Nephrol. 2014;25:339–48.

    Article  CAS  PubMed  Google Scholar 

  30. Lomashvili KA, Narisawa S, Millán JL, O’neill WC. Vascular calcification is dependent on plasma levels of pyrophosphate. Kidney Int. 2014;85:1351–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Lomashvili KA, Khawandi W, O’Neill WC. Reduced plasma pyrophosphate levels in hemodialysis patients. J Am Soc Nephrol. 2005;16:2495–500.

    Article  CAS  PubMed  Google Scholar 

  32. Cozzolino M, Mazzaferro S, Pugliese F, Brancaccio D. Vascular calcification and uremia: what do we know? Am J Nephrol. 2008;28:339–46.

    Article  PubMed  Google Scholar 

  33. Steitz SA, Speer MY, McKee MD, et al. Osteopontin inhibits mineral deposition and promotes regression of ectopic calcification. Am J Pathol. 2002;161:2035–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Bover J, Ureña P, Brandenburg V, et al. Adynamic bone disease: from bone to vessels in chronic kidney disease. Semin Nephrol. 2014;34:626–40.

    Article  PubMed  Google Scholar 

  35. Davies MR, Lund RJ, Hruska KA. BMP-7 is an efficacious treatment of vascular calcification in a murine model of atherosclerosis and chronic renal failure. J Am Soc Nephrol. 2003;14:1559–67.

    Article  PubMed  Google Scholar 

  36. Hu MC, Shi M, Zhang J, et al. Klotho deficiency causes vascular calcification in chronic kidney disease. J Am Soc Nephrol. 2011;22:124–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. ter Braake AD, Tinnemans PT, Shanahan CM, Hoenderop JG, de Baaij JH. Magnesium prevents vascular calcification in vitro by inhibition of hydroxyapatite crystal formation. Sci Rep. 2018;8:1–11.

    Google Scholar 

  38. Ruderman I, Holt SG, Hewitson TD, Smith ER, Toussaint ND. Current and potential therapeutic strategies for the management of vascular calcification in patients with chronic kidney disease including those on dialysis. Semin Dial. 2018;31:487–99.

    Article  PubMed  Google Scholar 

  39. Voelkl J, Lang F, Eckardt K, et al. Signaling pathways involved in vascular smooth muscle cell calcification during hyperphosphatemia. Cell Mol Life Sci. 2019;76:2077–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Shanahan CM, Crouthamel MH, Kapustin A, Giachelli CM. Arterial calcification in chronic kidney disease: key roles for calcium and phosphate. Circ Res. 2011;109:697–711.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Moe SM, Chen NX. Mechanisms of vascular calcification in chronic kidney disease. J Am Soc Nephrol. 2008;19:213–6.

    Article  CAS  PubMed  Google Scholar 

  42. Cozzolino M, Ciceri P, Galassi A, et al. The key role of phosphate on vascular calcification. Toxins. 2019;11:213.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Ray M, Jovanovich A. Mineral bone abnormalities and vascular calcifications. Adv Chronic Kidney Dis. 2019;26:409–16.

    Article  PubMed  Google Scholar 

  44. Mizobuchi M, Finch J, Martin D, Slatopolsky E. Differential effects of vitamin D receptor activators on vascular calcification in uremic rats. Kidney Int. 2007;72:709–15.

    Article  CAS  PubMed  Google Scholar 

  45. Thomas T, Gori F, Khosla S, Jensen MD, Burguera B, Riggs BL. Leptin acts on human marrow stromal cells to enhance differentiation to osteoblasts and to inhibit differentiation to adipocytes. Endocrinology. 1999;140:1630–8.

    Article  CAS  PubMed  Google Scholar 

  46. Poterucha TJ, Goldhaber SZ. Warfarin and vascular calcification. Am J Med. 2016;129:635. e1–4.

    Article  CAS  PubMed  Google Scholar 

  47. Chen NX, Duan D, O’Neill KD, Moe SM. High glucose increases the expression of Cbfa1 and BMP-2 and enhances the calcification of vascular smooth muscle cells. Nephrol Dial Transplant. 2006;21:3435–42.

    Article  CAS  PubMed  Google Scholar 

  48. Fernandez-Fernandez B, Martin-Cleary C, Ortiz A. Bicarbonate therapy, phosphate binders, and risk for vascular calcification. Kidney Int. 2014;86:1056.

    Article  CAS  PubMed  Google Scholar 

  49. Rothe H, Brandenburg V, Haun M, et al. Ecto-5′ -Nucleotidase CD73 (NT5E), vitamin D receptor and FGF23 gene polymorphisms may play a role in the development of calcific uremic arteriolopathy in dialysis patients – data from the German Calciphylaxis Registry. PLoS One. 2017;12:e0172407.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Rutsch F, Nitschke Y, Terkeltaub R. Genetics in arterial calcification: pieces of a puzzle and cogs in a wheel. Circ Res. 2011;109:578–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Hortells L, Sosa C, Guillén N, Lucea S, Millán Á, Sorribas V. Identifying early pathogenic events during vascular calcification in uremic rats. Kidney Int. 2017;92:1384–94.

    Article  CAS  PubMed  Google Scholar 

  52. Dobry AS, Ko LN, St John J, Sloan JM, Nigwekar S, Kroshinsky D. Association between hypercoagulable conditions and calciphylaxis in patients with renal disease: a case-control study. JAMA Dermatol. 2018;154:182–7.

    Article  PubMed  Google Scholar 

  53. Nigwekar SU, Wolf M, Sterns RH, Hix JK. Calciphylaxis from nonuremic causes: a systematic review. Clin J Am Soc Nephrol. 2008;3:1139–43.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Liu W, Zhang Y, Yu CM, et al. Current understanding of coronary artery calcification. J Geriatr Cardiol. 2015;12:668–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Jansz TT, Verhaar MC, London GM, van Jaarsveld BC. Is progression of coronary artery calcification influenced by modality of renal replacement therapy? A systematic review. Clin Kidney J. 2018;11:353–61.

    Article  CAS  PubMed  Google Scholar 

  56. Matsuoka M, Iseki K, Tamashiro M, et al. Impact of high coronary artery calcification score (CACS) on survival in patients on chronic hemodialysis. J Clin Exp Nephrol. 2004;8:54–8.

    Article  Google Scholar 

  57. Sigrist MK, Taal MW, Bungay P, McIntyre CW. Progressive vascular calcification over 2 years is associated with arterial stiffening and increased mortality in patients with stages 4 and 5 chronic kidney disease. Clin J Am Soc Nephrol. 2007;2:1241–8.

    Article  CAS  PubMed  Google Scholar 

  58. Ho CY, Shanahan CM. Medial arterial calcification: an overlooked player in peripheral arterial disease. Arterioscler Thromb Vasc Biol. 2016;36:1475–82.

    Article  CAS  PubMed  Google Scholar 

  59. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359:1761–7.

    Article  PubMed  Google Scholar 

  60. Sage AP, Tintut Y, Demer LL. Regulatory mechanisms in vascular calcification. Nat Rev Cardiol. 2010;7:528–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Adragao T, Pires A, Branco P, et al. Ankle – brachial index, vascular calcifications and mortality in dialysis patients. Nephrol Dial Transplant. 2012;27:318–25.

    Article  PubMed  Google Scholar 

  62. Chen TY, Lehman JS, Gibson LE, Lohse CM, El-Azhary RA. Histopathology of calciphylaxis: cohort study with clinical correlations. Am J Dermatopathol. 2017;39:795–802.

    Article  CAS  PubMed  Google Scholar 

  63. Seethapathy H, Noureddine L. Calciphylaxis: approach to diagnosis and management. Adv Chronic Kidney Dis. 2019;26:484–90.

    Article  PubMed  Google Scholar 

  64. SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103–16.

    Article  Google Scholar 

  65. Major RW, Cheung CK, Gray LJ, Brunskill NJ. Statins and cardiovascular primary prevention in CKD: a meta-analysis. Clin J Am Soc Nephrol. 2015;10:732–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Fellström BC, Jardine AG, Schmieder RE, et al. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med. 2009;360:1395–407.

    Article  PubMed  Google Scholar 

  67. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl (2011). 2017;7:1–59.

    Article  Google Scholar 

  68. Floege J. Calcium-containing phosphate binders in dialysis patients with cardiovascular calcifications: should we CARE-2 avoid them? Nephrol Dial Transplant. 2008;23:3050–52.

    Google Scholar 

  69. Chertow GM, Burke SK, Raggi P, Treat to Goal Working Group. Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patients. Kidney Int. 2002;62:245–52.

    Article  CAS  PubMed  Google Scholar 

  70. Block GA, Spiegel DM, Ehrlich J, et al. Effects of sevelamer and calcium on coronary artery calcification in patients new to hemodialysis. Kidney Int. 2005;68:1815–24.

    Article  CAS  PubMed  Google Scholar 

  71. Burke SK, Dillon MA, Hemken DE, Rezabek MS, Balwit JM. Meta-analysis of the effect of sevelamer on phosphorus, calcium, PTH, and serum lipids in dialysis patients. Adv Ren Replace Ther. 2003;10:133–45.

    Article  PubMed  Google Scholar 

  72. Zhang C, Wang S, Zhao S, Zhang X. Effect of lanthanum carbonate on coronary artery calcification and bone mineral density in maintenance hemodialysis patients with diabetes complicated with adynamic bone disease: a prospective pilot study. Medicine (Baltimore). 2017;96:e8664.

    Article  CAS  PubMed  Google Scholar 

  73. London GM, Marty C, Marchais SJ, Guerin AP, Metivier F, de Vernejoul MC. Arterial calcifications and bone histomorphometry in end-stage renal disease. J Am Soc Nephrol. 2004;15:1943–51.

    Article  PubMed  Google Scholar 

  74. Brandenburg VM, Kramann R, Rothe H, et al. Calcific uraemic arteriolopathy (calciphylaxis): data from a large nationwide registry. Nephrol Dial Transplant. 2016;32:126–32.

    Google Scholar 

  75. Floege J, Kubo Y, Floege A, Chertow GM, Parfrey PS. The effect of cinacalcet on calcific uremic arteriolopathy events in patients receiving hemodialysis: the EVOLVE trial. Clin J Am Soc Nephrol. 2015;10:800–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Nakayama K, Nakao K, Takatori Y, et al. Long-term effect of cinacalcet hydrochloride on abdominal aortic calcification in patients on hemodialysis with secondary hyperparathyroidism. Int J Nephrol Renovasc Dis. 2013;7:25–33.

    PubMed  PubMed Central  Google Scholar 

  77. Molnar AO, Biyani M, Hammond I, et al. Lower serum magnesium is associated with vascular calcification in peritoneal dialysis patients: a cross sectional study. BMC Nephrol. 2017;18:129.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Bressendorff I, Hansen D, Schou M, Pasch A, Brandi L. The effect of increasing dialysate magnesium on serum calcification propensity in subjects with end stage kidney disease: a randomized, controlled clinical trial. Clin J Am Soc Nephrol. 2018;13:1373–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Wang AY. Calcium balance and negative impact of calcium load in peritoneal dialysis patients. Perit Dial Int. 2014;34:345–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Shah M, Avgil Tsadok M, Jackevicius CA, et al. Warfarin use and the risk for stroke and bleeding in patients with atrial fibrillation undergoing dialysis. Circulation. 2014;129:1196–203.

    Article  CAS  PubMed  Google Scholar 

  81. Garza-Mayers AC, Shah R, Sykes DB, Nigwekar SU, Kroshinsky D. The successful use of apixaban in dialysis patients with calciphylaxis who require anticoagulation: a retrospective analysis. Am J Nephrol. 2018;48:168–71.

    Article  CAS  PubMed  Google Scholar 

  82. Portales-Castillo I, Kroshinsky D, Malhotra CK, et al. Calciphylaxis-as a drug induced adverse event. Expert Opin Drug Saf. 2019;18:29–35.

    Article  CAS  PubMed  Google Scholar 

  83. Farah M, Crawford RI, Levin A, Chan YC. Calciphylaxis in the current era: emerging ‘ironic’ features? Nephrol Dial Transplant. 2010;26:191–5.

    Article  PubMed  Google Scholar 

  84. Kirton JP, Wilkinson FL, Canfield AE, Alexander MY. Dexamethasone downregulates calcification-inhibitor molecules and accelerates osteogenic differentiation of vascular pericytes: implications for vascular calcification. Circ Res. 2006;98:1264–72.

    Article  CAS  PubMed  Google Scholar 

  85. Olaniran KO, Percy SG, Zhao S, et al. Palliative care use and patterns of end-of-life care in hospitalized patients with calciphylaxis. J Pain Symptom Manag. 2019;57:e1–3.

    Article  Google Scholar 

  86. Nigwekar SU, Brunelli SM, Meade D, Wang W, Hymes J, Lacson E Jr. Sodium thiosulfate therapy for calcific uremic arteriolopathy. Clin J Am Soc Nephrol. 2013;8:1162–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Zhang Y, Corapi KM, Luongo M, Thadhani R, Nigwekar SU. Calciphylaxis in peritoneal dialysis patients: a single center cohort study. Int J Nephrol Renovasc Dis. 2016;9:235–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. Zoccali C, London G. Con: vascular calcification is a surrogate marker, but not the cause of ongoing vascular disease, and it is not a treatment target in chronic kidney disease. Nephrol Dial Transplant. 2015;30:352–7.

    Article  CAS  PubMed  Google Scholar 

  89. Towler DA. Vascular calcification: a perspective on an imminent disease epidemic. IBMS BoneKey. 2008;5:41.

    Article  Google Scholar 

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Conflict of Interest/Financial Disclosure

S.U.N. reports grant support from Hope Pharmaceuticals to his institute and honoraria from Fresenius Renal Therapies, Epizon Pharma, and Laboratoris Sanifit.

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Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Ignacio A. Portales-Castillo & Sagar Nigwekar

  2. Harvard Medical School, Boston, MA, USA

    Ignacio A. Portales-Castillo & Sagar Nigwekar

  3. Division of Nephrology, University of Missouri-Columbia, Columbia, MO, USA

    Preethi Yerram

  4. Nephrology Section, Harry S Truman Veterans Administration Hospital, Columbia, MO, USA

    Preethi Yerram

  5. Division of Nephrology and Hypertension, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA

    Preethi Yerram

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  1. Ignacio A. Portales-Castillo
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  3. Sagar Nigwekar
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Correspondence to Sagar Nigwekar .

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Editors and Affiliations

  1. University of Missouri, Columbia, MO, USA

    Ramesh Khanna

  2. Dept. Medicine Div. Nephrology, University of Amsterdam Academic Medical Center, Amsterdam, The Netherlands

    Raymond T. Krediet

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Portales-Castillo, I.A., Yerram, P., Nigwekar, S. (2023). Vascular Calcification and Calciphylaxis in Peritoneal Dialysis Patients. In: Khanna, R., Krediet, R.T. (eds) Nolph and Gokal's Textbook of Peritoneal Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-030-62087-5_42

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