Vascular Calcification in Chronic Kidney Disease: The Role of Inflammation

Abstract

Cardiovascular complications are extremely frequent in patients with chronic kidney disease (CKD) and death from cardiac causes is the most common cause of death in this particular population. Cardiovascular disease is approximately 3 times more frequent in patients with CKD than in other known cardiovascular risk groups and cardiovascular mortality is approximately 10-fold more frequent in patients on dialysis compared to the age- and sex-matched segments of the nonrenal population. Among other structural and functional factors advanced calcification of atherosclerotic plaques as well as of the arterial and venous media has been described as potentially relevant for this high cardiovascular morbidity and mortality. One potential explanation for this exceedingly high vascular calcification in animal models as well as in patients with CKD increased systemic and most importantly local (micro)inflammation that has been shown to favor the development of calcifying particles by multiple ways. Of note, local vascular upregulation of proinflammatory and proosteogenic molecules is already present at early stages of CKD and may thus be operative for vascular calcification. In addition, increased expression of costimulatory molecules and mast cells has also been documented in patients with CKD pointing to a more inflammatory and potentially less stable phenotype of coronary atherosclerotic plaques in CKD.

Fasting plasma glucose, lipid ratios, and atherogenic coefficient are the risk factors for hypertension in chronic kidney disease patients on hemodialysis: A report from the Regional High Speciality Hospital of Peninsular Yucatan, Mexico

“…Therefore, CVD is reported to be responsible for morbidity and mortality in type 2 diabetes mellitus (T2DM) (Elsayed et al 2008). On the other hand, arterial vascular diseases namely atherosclerosis and arteriosclerosis are associated with CKD (Benz et al 2018;Bermudez-Lopez et al 2019;Moe and Chen 2004;Sarnak et al 2003;Stenvinkel et al 2003). Atherosclerosis is an inflammatory response to the endothelial wall damage.…”

Vascular calcification is associated with Wnt‐signaling pathway and blood pressure variability in chronic kidney disease rats

“…In the past, VC was recognized as a passive process from elevated calcium and phosphate levels. Recently, more and more studies revealed that VC involves an active process in which vascular smooth muscle cells (VSMCs) undergo a phenotypic transformation into osteoblast‐like cells, similar in many ways to bone metabolism . Despite extensive studies, the fundamental mechanisms responsible for VC in CKD and how VC contribute to the high cardiovascular mortality have not yet been fully elucidated.…”

Abdominal aortic calcification in predialysis patients: Contribution of traditional and uremia‑related risk factors

“…Ross (33) stated that atherosclerosis is an inflammatory disease. in CKD patients, inflammation is one of the key mediators of vessel wall calcification (34). in predialysis patients, severe coronary calcifications were associated with sFAs, a marker of inflammation, in the study of Tomiyama et al (14).…”