Table 1.

Key Mediators of Medial Vascular Calcification

Phosphate, bone, and mineral metabolism

Failure of/reduction in calcification inhibitors

Matrix Gla protein

Fetuin-A

Klotho (± FGF-23)

Pyrophosphate

Osteopontin

Increase in calcification promoters

Osteocalcin

Alkaline phosphatase

Inflammatory cytokines

Runx2

Phenotypic transdifferentiation of VSMCs (osteochondroblastic change)

Pro-calcific matrix vesicles

Uremic milieu

Cellular apoptosis

Pro-calcific miRNAs

FGF = fibroblast growth factor; miRNA = micro RNA; VSMC = vascular smooth muscle cell.