Pathophysiology of Vascular Calcification

Curr Osteoporos Rep. 2015 Dec;13(6):372-80. doi: 10.1007/s11914-015-0293-9.

Abstract

Vascular calcification can lead to cardiovascular morbidity and mortality. The initiating factors and clinical consequences depend on the underlying disease state and location of the calcification. The pathogenesis of vascular calcification is complex and involves a transformation of vascular smooth muscle cells to an osteo/chondrocytic cell that expresses RUNX2 and produces matrix vesicles. The imbalance of promoters (such as hyperphosphatemia and hypercalcemia) and inhibitors (e.g., fetuin-A) is critical in the development of vascular calcification. The altered mineral metabolism and deficiency in inhibitors are common in patients with chronic kidney disease (CKD) and is one reason why vascular calcification is so prevalent in that population.

Keywords: Calcification; Vascular calcification; Vascular smooth muscle cells.

Publication types

  • Review

MeSH terms

  • Bone Diseases, Metabolic / metabolism*
  • Bone Remodeling
  • Cell Differentiation*
  • Chondrocytes / metabolism
  • Core Binding Factor Alpha 1 Subunit / metabolism
  • Humans
  • Hypercalcemia / metabolism
  • Hyperphosphatemia / metabolism
  • Muscle, Smooth, Vascular / cytology
  • Muscle, Smooth, Vascular / metabolism*
  • Myocytes, Smooth Muscle / metabolism*
  • Osteocytes / metabolism*
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / metabolism*
  • Vascular Calcification / complications
  • Vascular Calcification / metabolism*

Substances

  • Core Binding Factor Alpha 1 Subunit