Vascular calcification in dialysis patients: Pathogenesis and consequences

Martina Reslerova, Sharon Moe

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Background: Vascular calcification is believed to have a crucial role in the excess cardiovascular mortality and morbidity in patients with end-stage renal disease (ESRD). Methods and Results: Recent evidence suggests that uremic vascular calcification is an active cell-mediated process resembling osteogenesis in bone, rather than passive precipitation of calcium and phosphorus in the setting of deranged mineral metabolism. To date, several bone-associated proteins (osteopontin, bone sialoprotein, alkaline phosphatase, and type I collagen) have been shown in histological sections of vessels obtained from patients with ESRD or calcific uremic arteriolopathy. In in vitro experiments, the addition of uremic serum upregulates osteopontin expression by cultured vascular smooth muscle cells (VSMCs). Conclusion: We are only beginning to understand the process by which VSMCs transform into osteoblast-like cells, although phosphorus may have a key role. Additional factors mediating or modulating the development of vascular calcification in patients with ESRD remain to be identified. Further understanding of the pathophysiological state of uremic vascular calcification is needed to design effective therapeutic strategies to intervene with this devastating condition in the ESRD population.

Original languageEnglish
JournalAmerican Journal of Kidney Diseases
Volume41
Issue number3 SUPPL. 1
StatePublished - Mar 1 2003

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Vascular Calcification
Chronic Kidney Failure
Dialysis
Osteopontin
Vascular Smooth Muscle
Phosphorus
Smooth Muscle Myocytes
Integrin-Binding Sialoprotein
Bone and Bones
Collagen Type I
Osteoblasts
Osteogenesis
Minerals
Alkaline Phosphatase
Up-Regulation
Calcium
Morbidity
Mortality
Serum
Population

Keywords

  • End-stage renal disease (ESRD)
  • Uremia
  • Vascular calcification

ASJC Scopus subject areas

  • Nephrology

Cite this

Vascular calcification in dialysis patients : Pathogenesis and consequences. / Reslerova, Martina; Moe, Sharon.

In: American Journal of Kidney Diseases, Vol. 41, No. 3 SUPPL. 1, 01.03.2003.

Research output: Contribution to journalArticle

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