Vascular Calcification in Chronic Kidney Disease

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Dialysis patients have increased cardiovascular morbidity, mortality, and vascular calcification, and the latter appears to impact the former. Recent evidence indicates that vascular calcification is an active, cell-mediated process. Osteoblast differentiation factor Cbfa1 and several bone-associated proteins (osteopontin, bone sialo-protein, alkaline phosphatase, type I collagen) are present in histologic sections of arteries obtained from patients with end-stage renal disease (chronic kidney disease stage V [CKD-V]). This supports the theory that vascular smooth muscle cells can dedifferentiate or transform to osteoblast-like cells, possibly by up-regulation of Cbfa1. In in vitro experiments, addition of pooled serum from dialysis patients (versus normal healthy controls) accelerated mineralization and increased expression of Cbfa1, osteopontin, and alkaline phosphatase in cultured vascular smooth muscle cells. Clinically, the pathogenesis of vascular calcification is not completely understood, although increased levels of phosphorus and/or other potential uremic toxins may play an important role by transforming vascular smooth muscle cells into osteoblast-like cells. Presumably, once this process begins, increased serum calcium X phosphorus product, or calcium load from binders, accelerates this process. In addition, it is likely that circulating inhibitors of calcification are also important. Further understanding of the pathophysiology of vascular calcification is needed to intervene appropriately.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalSeminars in Nephrology
Volume24
Issue number1
DOIs
StatePublished - Jan 2004

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Vascular Calcification
Chronic Renal Insufficiency
Osteoblasts
Vascular Smooth Muscle
Smooth Muscle Myocytes
Osteopontin
Phosphorus
Alkaline Phosphatase
Dialysis
Calcium
Bone and Bones
Phosphoprotein Phosphatases
Collagen Type I
Serum
Chronic Kidney Failure
Up-Regulation
Arteries
Morbidity
Mortality
Proteins

ASJC Scopus subject areas

  • Nephrology

Cite this

Vascular Calcification in Chronic Kidney Disease. / Chen, Xuening (Neal); Moe, Sharon.

In: Seminars in Nephrology, Vol. 24, No. 1, 01.2004, p. 61-68.

Research output: Contribution to journalArticle

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