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Arterial Calcification in Chronic Kidney Disease: Key Roles for Calcium and Phosphate

Open access
Shanahan, Catherine M., Crouthamel, Matthew H., Kapustin, Alexander, Giachelli, Cecilia M.·2011·Circulation Research

Abstract

Vascular calcification contributes to the high risk of cardiovascular mortality in chronic kidney disease (CKD) patients. Dysregulation of calcium (Ca) and phosphate (P) metabolism is common in CKD patients and drives vascular calcification. In this article, we review the physiological regulatory mechanisms for Ca and P homeostasis and the basis for their dysregulation in CKD. In addition, we highlight recent findings indicating that elevated Ca and P have direct effects on vascular smooth muscle cells (VSMCs) that promote vascular calcification, including stimulation of osteogenic/chondrogenic differentiation, vesicle release, apoptosis, loss of inhibitors, and extracellular matrix degradation. These studies suggest a major role for elevated P in promoting osteogenic/chondrogenic differentiation of VSMC, whereas elevated Ca has a predominant role in promoting VSMC apoptosis and vesicle release. Furthermore, the effects of elevated Ca and P are synergistic, providing a major stimulus for vascular calcification in CKD. Unraveling the complex regulatory pathways that mediate the effects of both Ca and P on VSMCs will ultimately provide novel targets and therapies to limit the destructive effects of vascular calcification in CKD patients.

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Crossref · 10.1161/circresaha.110.234914

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Metadata

Authors
Shanahan, C. M., Crouthamel, M. H., Kapustin, A., & Giachelli, C. M.
Venue
Circulation Research
Published
2011-09-02
Volume
109
Issue
6
Pages
697-711
ISSN
  • 0009-7330 (ISSN-L)
  • 1524-4571
OpenAlex
W2108116509
Cited by
958
References
6
FWCI
35.08
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Arterial Calcification in Chronic Kidney Disease: Key Roles for Calcium and Phosphate. https://app.cochat.ai/papers/10.1161/circresaha.110.234914
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Shanahan, C. M., Crouthamel, M. H., Kapustin, A., & Giachelli, C. M. (2011). Arterial Calcification in Chronic Kidney Disease: Key Roles for Calcium and Phosphate. Circulation Research. https://doi.org/10.1161/circresaha.110.234914

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Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.