Role for alkaline phosphatase as an inducer of vascular calcification in renal failure?

Vascular calcification is associated with increased cardiovascular morbidity and mortality. A number of calcification inhibitors have been defined recently, including inorganic pyrophosphate (PPi), an important physicochemical inhibitor of hydroxyapatite crystal growth. Increased hydrolysis of PPi by tissue-nonspecific alkaline phosphatase (TNAP) may occur in renal failure and act to enhance mineralization of vessels.