Journal
ADVANCES IN CHRONIC KIDNEY DISEASE
Volume 26, Issue 6, Pages 417-426Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.ackd.2019.08.014
Keywords
Endothelium; Calciprotein particles; Fetuin-A; Matrix-gla protein; Magnesium
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The increase in prevalence and severity of vascular calcification in chronic kidney disease is a result of complex interactions between changes in the vascular bed, mineral metabolites, and other uremic factors. Vascular calcification can occur in the intima and the media of arterial wall. Under permissive conditions, vascular smooth muscle cells (VSMCs) can transform to osteoblast-like phenotype. The membrane-bound vesicles released from transformed VSMCs and the apoptotic bodies derived from dying VSMCs serve as nucleating structures for calcium crystal formation. Alterations in the quality and the quantity of endogenous calcification inhibitors also give rise to an environment that potentiates calcification. (C) 2019 by the National Kidney Foundation, Inc. All rights reserved.
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