Current Osteoporosis Reports

, Volume 13, Issue 4, pp 206–215 | Cite as

Molecular Mechanisms of Vascular Calcification in Chronic Kidney Disease: The Link between Bone and the Vasculature

  • Chang Hyun Byon
  • Yabing ChenEmail author
Kidney and Bone (SM Moe and IB Salusky, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Kidney and Bone


Vascular calcification is highly prevalent in patients with chronic kidney disease (CKD) and increases mortality in those patients. Impaired calcium and phosphate homeostasis, increased oxidative stress, and loss of calcification inhibitors have been linked to vascular calcification in CKD. Additionally, impaired bone may perturb serum calcium/phosphate and their key regulator, parathyroid hormone, thus contributing to increased vascular calcification in CKD. Therapeutic approaches for CKD, such as phosphate binders and bisphosphonates, have been shown to ameliorate bone loss as well as vascular calcification. The precise mechanisms responsible for vascular calcification in CKD and the contribution of bone metabolism to vascular calcification have not been elucidated. This review discusses the role of systemic uremic factors and impaired bone metabolism in the pathogenesis of vascular calcification in CKD. The regulation of the key osteogenic transcription factor Runt-related transcription factor 2 (Runx2) and the emerging role of Runx2-dependent receptor activator of nuclear factor kappa-B ligand (RANKL) in vascular calcification of CKD are emphasized.


Chronic kidney disease Vascular calcification Bone loss PTH Runx2 RANKL 



Due to the scope and limitation, we apologize for not being able to include all the important work in the field. The authors thank Jay M. McDonald, MD (University of Alabama at Birmingham, UAB) for critical review. The original research programs of the authors are supported by grants from the National Institutes of Health, HL092215 and DK100847, and Veterans Administration BX000369 and BX001591 (project 2) to YC.

Compliance with Ethics Guidelines

Conflict of Interest

CH Byon and Y Chen both declare no conflicts of interest.

Human and Animal Rights and Informed Consent

All studies by the authors involving animal and/or human subjects were performed after approval by the appropriate institutional review boards. When required, written informed consent was obtained from all participants.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of PathologyUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of PathologyBirmingham Veterans Affairs Medical CenterBirminghamUSA

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