Related Experiment Video
Updated: Aug 16, 2026
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Vascular calcification in patients with renal failure: culprit or innocent bystander?
Santo Dellegrottaglie1, Rajiv Saran, Sanjay Rajagopalan
1Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA.
Insights
Vascular calcification (VC) is common in chronic kidney disease (CKD) and dialysis patients, contributing to high cardiovascular mortality. Further research is needed to understand VC
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Cardiovascular event mortality is significantly higher in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) compared to the general population.
- Vascular calcification (VC) is prevalent and rapidly progressive in CKD and dialysis patients, contributing to this increased mortality.
- While calcium and phosphate are key players, the paracrine and molecular mechanisms driving VC in renal failure are still being elucidated.
Purpose of the Study:
- To review the current understanding of vascular calcification (VC) pathogenesis in CKD.
- To highlight evolving knowledge on molecular determinants and inhibitors of VC.
- To discuss the clinical utility of noninvasive VC detection and its prognostic potential in renal failure patients.
Main Methods:
- Review of existing literature on vascular calcification (VC) in chronic kidney disease (CKD).
- Discussion of molecular pathways and signaling molecules involved in VC.
- Evaluation of noninvasive imaging techniques for VC detection.
Main Results:
- Vascular calcification (VC) is a dynamic process influenced by an imbalance between pro-calcifying and anti-calcifying factors.
- Emerging molecules like osteoprotegerin, fetuin-A, and MPG are key in understanding VC.
- Noninvasive imaging (EBCT, MDCT) allows for VC detection and quantification.
Conclusions:
- Vascular calcification (VC) is a significant issue in CKD and ESRD, linked to high cardiovascular mortality.
- Understanding the molecular determinants of VC is crucial for developing targeted therapies.
- Prospective studies are needed to validate the prognostic value of VC in CKD and ESRD populations.
Abstract:
The mortality from cardiovascular events in CKD and dialysis patients is substantially higher than in the general population. VC is ubiquitous and progresses rapidly in this patient population. Although there has been progress in the understanding of the pathogenesis and correlates of VC, much work needs to be done in this area. The role of calcium and, probably, phosphate (obligatory participants) is unquestionable, but the understanding of the paracrine and molecular determinants of VC in renal failure is continuously evolving. VC is probably a dynamic process resulting from the imbalance between molecules that promote and those that inhibit VC. The understanding of latter area has recently evolved with identification of new signaling pathways with molecules such as osteoprotegerin, fetuin-A, and MPG. From a clinical perspective, new modalities such as EBCT and MDCT allow noninvasive detection and quantification of VC. VC may represent a potential useful index for prognostic stratification and treatment planning in patients who have renal failure. At present, however, the data on the prognostic value of VC are available only in populations of patients who have normal renal function. Large-scale, prospective, observational studies should be designed to identify the determinants of VC and to define the prognostic role of calcium scoring in cohorts of patients who have predialysis CKD and with ESRD.
Related Concept Videos
01:28Urinary Tract Calculi I: Introduction
01:21Skeleton and Calcium Homeostasis
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
01:24Chronic Kidney Disease II: Clinical Manifestations