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Updated: Jun 9, 2026

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
08:43

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation

Published on: May 31, 2016

Determinants of progressive vascular calcification in haemodialysis patients

Glenn M Chertow1, Paolo Raggi, Scott Chasan-Taber

  • 1Division of Nephrology, Moffitt-Long Hospitals and UCSF-Mt. Zion Medical Center, Department of Medicine, University of California San Francisco, 94118-1211, USA. chertowg@medicine.ucsf.edu

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|April 23, 2004
PubMed

Insights

Calcium-based phosphate binders worsen vascular calcification, especially with uncontrolled mineral metabolism. Sevelamer offers a safer alternative, potentially impacting lipids and calcification differently.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Mineral Metabolism

Background:

  • Calcium-based phosphate binders (calcium acetate, carbonate) linked to progressive coronary artery and aortic calcification.
  • Non-calcium binder, sevelamer, did not show this association.
  • Hypothesized other factors beyond calcium influence calcification progression.

Purpose of the Study:

  • Investigate determinants of progressive vascular calcification.
  • Compare factors influencing calcification in calcium-binder vs. sevelamer groups.

Main Methods:

  • 150 randomized subjects underwent electron beam tomography (EBT) at baseline and follow-up.
  • Explored associations between mineral levels, parathyroid hormone (PTH), albumin, and calcification progression.
  • Analyzed data separately for calcium-binder and sevelamer treatment groups.

Main Results:

  • Higher calcium, phosphorus, and calcium-phosphorus product correlated with increased EBT scores in calcium-treated subjects.
  • No such association found in sevelamer-treated subjects.
  • PTH showed complex associations; albumin inversely correlated with aortic calcification progression. Sevelamer improved lipids.

Conclusions:

  • Calcium-based binders promote vascular calcification, particularly with poor mineral control.
  • Calcium may negatively impact skeletal and extraskeletal calcification, potentially via PTH.
  • Sevelamer demonstrates a potentially favorable profile regarding vascular calcification and lipids.
Abstract

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