Targeting Vascular Calcification in Chronic Kidney Disease

JACC Basic Transl Sci. 2020 Apr 27;5(4):398-412. doi: 10.1016/j.jacbts.2020.02.002. eCollection 2020 Apr.

Abstract

Cardiovascular (CV) disease remains an important cause of morbidity and mortality for patients with chronic kidney disease (CKD). Although clustering of traditional risk factors with CKD is well recognized, kidney-specific mechanisms are believed to drive the disproportionate burden of CV disease. One perturbation that is frequently observed at high rates in patients with CKD is vascular calcification, which may be a central mediator for an array of CV sequelae. This review summarizes the pathophysiological bases of intimal and medial vascular calcification in CKD, current strategies for diagnosis and management, and posits vascular calcification as a risk marker and therapeutic target.

Keywords: CAC, coronary artery calcification; CI, confidence interval; CKD, chronic kidney disease; CT, computed tomography; CV, cardiovascular; CVD, cardiovascular disease; ESKD, end-stage kidney disease; FGF, fibroblast growth factor; HR, hazard ratio; LDL-C, low-density lipoprotein cholesterol; MGP, matrix Gla protein; PTH, parathyroid hormone; VSMC, vascular smooth muscle cell; chronic kidney disease; dialysis; eGFR, estimated glomerular filtration rate; medial calcification; vascular calcification.

Publication types

  • Review