Medial and Intimal Calcification in Chronic Kidney Disease: Stressing the Contributions

C ardiovascular calcification is a prominent feature ofchronic inflammatory disorders that associate with significant morbidity and mortality. Vascular calcification is highly prevalent in patients with chronic kidney disease (CKD), a multifactorial disorder. CKD often results from hypertension and diabetes, and patients with CKD are among the highest-risk groups for cardiovascular events. Notably, CKD accelerates the development of atherosclerosis. Our group and others have demonstrated that CKD causes excessive vascular inflammation and calcification.1 CKD is characterized by increased serum phosphate levels, which is, in turn, associated with the progression of calcification. But phos-phate binder therapy reportedly has no effect on vascular calcification in CKD patients,2 suggesting that targeting phosphate alone cannot improve vessel stiffness. A variety of other therapies, which have produced mixed results at best