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Updated: Jun 29, 2026
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
[Clinical advances in vascular calcification]
1Servicio de Nefrologia, Hospital Arnau de Vilanova (IRB Lleida), Spain.
Insights
Vascular calcification is a predictor of mortality in dialysis patients and the general population. While no treatments currently reverse it, sevelamer may slow progression in new hemodialysis patients.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Vascular calcification is a significant clinical concern, impacting morbidity and mortality in both dialysis patients and the general population.
- Arterial stiffness, closely related to vascular calcification, also serves as a prognostic indicator.
- Markers like fetuin-A show associations with mortality, particularly in hemodialysis patients.
Purpose of the Study:
- To review and synthesize current clinical knowledge on vascular calcification.
- To address key questions regarding its measurement, significance, causes, and treatment.
Main Methods:
- Systematic review of selected articles focusing on clinical utility and evidence.
- Analysis of studies quantifying vascular calcification and arterial stiffness.
- Evaluation of research on etiological factors and therapeutic interventions.
Main Results:
- Vascular calcification and arterial stiffness are established prognostic factors for morbidity and mortality.
- Low bone turnover and diabetes are identified causes of cardiovascular disease and vascular calcification.
- Sevelamer demonstrated potential in slowing vascular calcification progression and improving survival in new hemodialysis patients compared to calcium compounds.
Conclusions:
- Currently, no definitive treatments exist for the regression of vascular calcification.
- Sevelamer may offer benefits in slowing progression and improving survival, especially in specific patient subgroups.
- Further clinical studies are needed to confirm the efficacy of agents like paricalcitol and cinacalcet.
Abstract:
The articles providing answers to the questions on vascular calcification of most interest from a clinical point of view were selected. 1. How is it measured?: Studies showing the clinical utility of different tools to quantify it were analyzed. 2. What does it measure?: Both in dialysis patients and the general population, vascular calcification and arterial stiffness are prognostic factors for morbidity and mortality. Other markers such as fetuin-A are associated with mortality in patients on hemodialysis but not in patients in early stages of chronic kidney disease. 3. What causes it?: In two selected studies, it was demonstrated again that low bone turnover and diabetes cause cardiovascular disease and vascular calcification, respectively. 4. How is it treated?: There is still no clinical evidence of regression of vascular calcification. However, a prospective study in new hemodialysis patients showed that sevelamer compared to calcium compounds slows the progression of vascular calcification and confers greater survival. A study comparing both compounds in chronic hemodialysis patients showed that sevelamer only had a benefit on survival in patients older than 65 years. It remains to be demonstrated whether the good experimental results of paricalcitol and cinacalcet are confirmed in prospective clinical studies.
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