Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality

Abstract

AMC is a strong prognostic marker of all-cause and CV mortality in HD patients, independently of classical atherogenic factors. The principal effect of AMC on arterial function is increased arterial stiffness.

Insulin attenuates vascular smooth muscle calcification but increases vascular smooth muscle cell phosphate transport

“…LY294002 and U0126 were from Cell Signaling Technology (Beverly, MA) and PD98059 from Calbiochem (San Diego, CA). 32 PO 4 was obtained from Perkin Elmer (Boston, MA) as orthophosphoric acid. Specific type III sodium-phosphate co-transporter (Pit-1 and Pit-2) antibodies were from Alpha Diagnostic International (San Antonio, TX).…”

“…Just prior to uptake experiments, the VSMC monolayers were rinsed at 37°C with transport solution containing 137 mM NaCl, 5.4 mM KCl, 2.8 mM CaCl 2 , 1.2 mM MgSO4, and 14 mM HEPES, pH 7.4 (15). To measure total sodium-phosphate (Na/Pi) co-transport, VSMC were incubated with 500 μl of transport solution also containing 0.05 mM K 2 H 32 PO 4 . To measure Na-independent phosphate (Pi) uptake, sodium chloride (NaCl) was substituted equimolarly with choline chloride in the washing and uptake solutions.…”

“…Medial artery calcification is an independent predictor of cardiovascular mortality in individuals with type 2 diabetes mellitus (1-3) and end-stage renal disease (4). The mechanisms for vascular calcification in these clinical settings are still being elucidated (5,6), but increased vascular calcification is clearly associated with hyperphosphatemia (7) and with increased serum calcium-phosphate ion product.…”

Advanced Oxidation Protein Products Induce Vascular Calcification by Promoting Osteoblastic Trans-Differentiation of Smooth Muscle Cells via Oxidative Stress and ERK Pathway

“…Increased vascular calcification in CKD patients is reported to be associated with both overall and cardiovascular-related morbidity and mortality. [1][2][3][4][5][6] Accumulating evidence suggests that vascular calcification resembles developmental bone mineralization, with the production of "bone" proteins by vascular smooth muscle cells (VSMCs), such as osteopontin (OPN) and type-I collagen. [7][8][9][10][11] Furthermore, a recent study [12] demonstrates that the addition of uremic serum to cultured VSMCs accelerated mineralization and up-regulated the expression of osteopontin and core binding factor-a1 (CBF-a1), a transcription factor that is important for osteoblast differentiation and bone matrix protein expression.…”

Malnutrition–inflammation complex syndrome: link between end-stage renal disease, atherosclerosis and valvular calcification

“…Vascular calcification and arterial stiffness are independent predictors of mortality in dialysis patients. 2 Moreover, there is a strong association between valvular calcification (VC) and aortic stiffness in patients with ESRD 3 (Figure 1). Dystrophic calcification, which was first described by Möckenberg in 1904, is characteristically localized in the tunica media and is the most common pathological finding in operatively excised heart valves.…”