The emerging role of phosphate in vascular calcification Cecilia M. Giachelli  Kidney International  Volume 75, Issue 9, Pages 890-897 (May 2009) DOI: 10.1038/ki.2008.644 Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 1 Major mechanisms of vascular calcification. Six different mechanisms that have been proposed to regulate the initiation or progression of vascular calcification are illustrated, along with key molecular mediators where known. The extent to which each of these mechanisms plays a role in vascular calcification in various disease states, including hyperphosphatemia and ESRD, is currently unknown. cMGP; gamma carboxylated matrix gla protein, pOPN; phosphorylated osteopontin. Kidney International 2009 75, 890-897DOI: (10.1038/ki.2008.644) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 2 Proposed role of elevated phosphate (Pi) in osteochondrogenic phenotype change and matrix mineralization in vascular SMC. Pi enters the cell through the sodium-dependent phosphate cotransporter, Pit-1, and induces an osteochondrogenic phenotype change. This stimulates matrix vesicle calcium and Pi loading, as well as matrix changes that promote calcification. Molecules involved in regulating Pi loading of matrix vesicles or Pi efflux are currently unknown. Kidney International 2009 75, 890-897DOI: (10.1038/ki.2008.644) Copyright © 2009 International Society of Nephrology Terms and Conditions