Mechanisms of arterial calcifications and consequences for cardiovascular function

Cardiovascular complications are the leading cause of mortality in chronic (CKD) and end-stage renal disease (ESRD). The risk of developing cardiovascular complications is associated with changes in the structure and function of the arterial system, which are in many aspects similar to those occurring with aging. The presence of traditional risk factors does not fully explain the extension and severity of arterial disease. Therefore, other factors associated with CKD and ESRD must also be involved. Arterial calcification (AC) is a common complication of CKD and ESRD, and the extent of AC in general population as well as in patients with CKD is predictive of subsequent cardiovascular mortality beyond established conventional risk factors. AC is an active process similar to bone formation that implicates a variety of proteins involved in bone and mineral metabolism and is considered part of a systemic dysfunction defined as CKD-associated mineral and bone disorder (CKD-MBD).