Bone–Vascular Axis in Chronic Kidney Disease

hronic kidney disease (CKD) is characterized by changes in mineral metabolism associated with alter- ations of its hormonal regulation and various forms of bone disease. In the past, these associations focused attention on the kidney-bone axis. The last decade has seen renewed interest on interactions among mineral metabolism disorders and extraosseous and cardiovascular calcifications observed in CKD or end-stage renal disease (ESRD). Vascular calcification is an active process similar to bone formation that implicates a variety of proteins involved in bone and mineral metabolism (1,2) and is considered part of a systemic dysfunction defined as CKD-mineral and bone disorder (3). Growing evidence link- ing bone with different functional and structural characteristics of the arterial tree has contributed to developing the concept of