Siracusa Chiara, Carabetta Nicole, Morano Maria Benedetta, Manica Marzia, Strangio Antonio, Sabatino Jolanda, Leo Isabella, Castagna Alberto, Cianflone Eleonora, Torella Daniele, Andreucci Michele, Zicarelli Maria Teresa, Musolino Michela, Bolignano Davide, Coppolino Giuseppe, De Rosa Salvatore
Department of Medical and Surgical Sciences, "Magna Grecia" University, 88100 Catanzaro, Italy.
Department of Experimental and Clinical Medicine, "Magna Grecia" University, 88100 Catanzaro, Italy.
Int J Mol Sci. 2024 Dec 5;25(23):13096. doi: 10.3390/ijms252313096.
Vascular calcification (VC) is a biological phenomenon characterized by an accumulation of calcium and phosphate deposits within the walls of blood vessels causing the loss of elasticity of the arterial walls. VC plays a crucial role in the incidence and progression of chronic kidney disease (CKD), leading to a significant increase in cardiovascular mortality in these patients. Different conditions such as age, sex, dyslipidemia, diabetes, and hypertension are the main risk factors in patients affected by chronic kidney disease. However, VC may occur earlier and faster in these patients if it is associated with new or non-traditional risk factors such as oxidative stress, anemia, and inflammation. In chronic kidney disease, several pathophysiological processes contribute to vascular calcifications, including osteochondrogenic differentiation of vascular cells, hyperphosphatemia and hypercalcemia, and the loss of specific vascular calcification inhibitors including pyrophosphate, fetuin-A, osteoprotegerin, and matrix GLA protein. In this review we discuss the main traditional and non-traditional risk factors that can promote VC in patients with kidney disease. In addition, we provide an overview of the main pathogenetic mechanisms responsible for VC that may be crucial to identify new prevention strategies and possible new therapeutic approaches to reduce cardiovascular risk in patients with kidney disease.
血管钙化（VC）是一种生物学现象，其特征是血管壁内钙和磷酸盐沉积积聚，导致动脉壁弹性丧失。血管钙化在慢性肾脏病（CKD）的发生和发展中起关键作用，导致这些患者心血管死亡率显著增加。不同的情况，如年龄、性别、血脂异常、糖尿病和高血压，是慢性肾脏病患者的主要危险因素。然而，如果血管钙化与氧化应激、贫血和炎症等新的或非传统危险因素相关，则在这些患者中可能更早、更快地发生。在慢性肾脏病中，几种病理生理过程促成血管钙化，包括血管细胞的骨软骨分化、高磷血症和高钙血症，以及特定血管钙化抑制剂的丧失，包括焦磷酸盐、胎球蛋白-A、骨保护素和基质GLA蛋白。在这篇综述中，我们讨论了可促进肾病患者血管钙化的主要传统和非传统危险因素。此外，我们概述了导致血管钙化的主要发病机制，这对于确定新的预防策略以及可能的新治疗方法以降低肾病患者的心血管风险可能至关重要。
