| Theme |
Ectopic calcification on soft tissue: Vascular calcification and cardiac valvular calcification |
| Title |
Oxidative stress and vascular calcification |
| Author |
Shunsuke Yamada |
Nephrology, Hypertention and Strokology, Kyushu University Hospital |
| Author |
Hokuto Arase |
Department of Medicine and Clinical Science, Graduate School of Mediccal Sciences, Kyushu University |
| Author |
Toshiaki Nakano |
Nephrology, Hypertention and Strokology, Kyushu University Hospital |
| [ Summary ] |
Vascular calcification, highly prevalent in patients with chronic kidney disease (CKD), is closely associated with an increased risk of cardiovascular mortality. In CKD patients, both intimal and medial calcification are accentuated. A variety of pathogeneses observed in uremic milieu play critical roles in the progression of vascular calcification in CKD. In this chapter, we focused on the impact of oxidative stress on uremic vascular calcification. Oxidative stress is increased in CKD and greatly contributes to the pathogenesis of various organ dysfunction related to the uremic milieu. Based on previous reports, oxidative stress is involved in both intimal and medial calcification and induces transdifferentiation of vascular smooth muscle cells (VSMCs), apoptosis of VSMCs, degradation of extracellular matrix and synthesis and secretion of matrix vesicles. All these calcifying processes accelerate deposition of hydroxyapatite around the extracellular matrix. In clinical practice, some of the anti-oxidants are reported to be effective for the prevention of cardiovascular events. However, few studies have focused on the impact of antioxidants on vascular calcification in patients with CKD. Future studies should be directed towards answering the query whether antioxidants prevent vascular calcification and reduce the risk for mortality in CKD population. |