Vascular Calcifi cation in Chronic Kidney Disease

The most common cause of death in patients with end-stage renal disease is cardiovascular (CV) disease. Vascular calcifi cation (VC) is a CV risk factor among dialysis patients. Advanced age, dialysis adequacy, vitamin D therapy and calcium-containing phosphate binders are additional clinical risk factors associated with VC. However, VC is a dynamic and programmed process and cannot only be attributed to passive calcium phosphate deposition. Osteoprotegerin, receptor activator nuclear factor kB (RANK) and its ligand (RANKL), along with the monocyte colony stimulating factor (M-CSF) and the transcription factor core binding protein (Cbfa-1) play a pivotal role in the control of VC. In contrast, Fetuin-A, matrix Gla protein (MGP) and osteopontin (OPN) can control the inhibition of VC. VC can be diagnosed in clinical practice with multi-detector computed tomography (MDCT) and electron beam computed tomography (EBCT).