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Editor's Correspondence |

Phosphorus-Related Mechanisms of Vascular Calcification

Vincenzo Savica, MD; Guido Bellinghieri, MD; Domenico Santoro, MD
Arch Intern Med. 2007;167(21):2368. doi:10.1001/archinte.167.21.2368-a.
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Recently, Dhingra et al1 reported relations of increase in serum phosphorus and calcium levels in the incidence of cardiovascular disease in individuals without chronic kidney disease. In chronic kidney disease, the relation between hyperphosphatemia and cardiovascular calcification was identified, and high mortality and morbidity due to cardiovascular calcification were reported.2 According to Dhingra et al,1 potential mechanisms of the proven relation between cardiovascular calcification and increased serum phosphorus level may include inhibition of 1,25-dihydroxyvitamin D synthesis, direct promotion of vascular injury by an increase in phosphorus level, increased osteopontin expression, increased calcium and phosphorus product, subclinical renal dysfunction, and increased parathyroid hormone level caused by a high serum phosphorus level.1,2

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