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Updated: Jul 15, 2025
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Future treatment of vascular calcification in chronic kidney disease
Mario Cozzolino1, Federico Maffei Faccioli1, Anila Cara1
1Renal Division, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy.
Insights
Vascular calcification (VC) in chronic kidney disease (CKD) patients contributes to cardiovascular disease (CVD). This review details VC pathophysiology, biomarkers, and current/emerging treatments to improve patient outcomes.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Cardiovascular disease (CVD) is a primary cause of death in chronic kidney disease (CKD) patients.
- Vascular calcification (VC) significantly drives CVD in CKD, stemming from complex molecular interactions.
- Pathological VC involves endothelial dysfunction, oxidative stress, inflammation, and altered mineralization inhibitors.
Purpose of the Study:
- To review the pathophysiology of vascular calcification (VC) in chronic kidney disease (CKD).
- To summarize current biomarkers for VC.
- To focus on existing and novel treatment strategies for VC in CKD patients.
Main Methods:
- Comprehensive literature review.
- Synthesis of existing research on VC pathophysiology.
- Analysis of current and experimental therapeutic approaches.
Main Results:
- VC results from an imbalance of calcification promoters and inhibitors.
- Biomarkers for VC are under investigation.
- Current treatments focus on mineral balance, vitamin deficiencies, bone turnover, and inflammation.
Conclusions:
- Targeting cellular mechanisms and developing predictive scores are crucial for managing VC.
- Improved therapeutic strategies are needed to reduce CVD morbidity and mortality in CKD.
- Early detection and targeted therapies are essential for better patient management.
Introduction:
Cardiovascular disease (CVD) is one of the global leading causes of morbidity and mortality in chronic kidney disease (CKD) patients. Vascular calcification (VC) is a major cause of CVD in this population and is the consequence of complex interactions between inhibitor and promoter factors leading to pathological deposition of calcium and phosphate in soft tissues. Different pathological landscapes are associated with the development of VC, such as endothelial dysfunction, oxidative stress, chronic inflammation, loss of mineralization inhibitors, release of calcifying extracellular vesicles (cEVs) and circulating calcifying cells.
Areas Covered:
In this review, we examined the literature and summarized the pathophysiology, biomarkers and focused on the treatments of VC.
Expert Opinion:
Even though there is no consensus regarding specific treatment options, we provide the currently available treatment strategies that focus on phosphate balance, correction of vitamin D and vitamin K deficiencies, avoidance of both extremes of bone turnover, normalizing calcium levels and reduction of inflammatory response and the potential and promising therapeutic approaches liketargeting cellular mechanisms of calcification (e.g. SNF472, TNAP inhibitors).Creating novel scores to detect in advance VC and implementing targeted therapies is crucial to treat them and improve the future management of these patients.
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