ATP and arterial calcification


Correspondence to: Dr Richard Fish, UCL Centre for Nephrology, UCL Medical School, 2nd Floor, Royal Free Hospital, Hampstead, London NW3 2QG, UK. Tel.: +44 (0)207 794 0500 ext 38061; fax +44 (0)207 317 8591; e-mail



Arterial calcification (AC) is a major health problem associated with extreme morbidity and a shortened survival. It is currently without any effective treatment. ATP and the purinergic system in general are now emerging as being important in the pathogenesis of AC and potentially provide a new focus for novel therapies.


This review systematically analyses and discusses the current literature examining the relevance of the purinergic system to AC. Particular emphasis is given to the enzymes associated with ATP metabolism and their role in maintaining a balance between promotion and inhibition of arterial mineralization. Points of controversy are highlighted, and areas for future research are suggested.


The potential roles of ATP and the purinergic system in AC are beginning to be elucidated. While further work is necessary, current knowledge suggests that several components of the purinergic system could be targeted to develop new treatments for AC.