Nephrogenic Calcific Arteriopathy

Introduction

Vascular calcification in chronic kidney disease (CKD) is extremely common and contributes to significant morbidity and mortality among these patients. The pathogenesis is complex and involves multiple factors, including elevated calcium x phosphorus product as well as deficiencies in circulating or locally produced inhibitors of calcification, parathyroid hormone, hyperlipidemia and inflammation. Similarly, valvular heart calcifications as well as myocardial and pulmonary calcifications of fatal consequences can also occur, presumably related to the same pathogenetic factors (Figures 1, 2). Other forms of extraskeletal tissue calcification of nonfatal consequences but leading to incapacity can also develop in CKD patients (Figure 3). These complications may be prevented by awareness and early intervention directed towards correcting some of the aforementioned participating mechanisms.