We recently reported that activation of the activating transcription factor 4 (ATF4) pathway through the saturated fatty acid (SFA)-induced endoplasmic reticulum (ER) stress response plays a causative role in CKD-associated vascular calcification.
Serum PTH and bone PTH1R/ATF4 expression was elevated in CKD-3 compared with other groups, and it positively correlated with femur weight, BMD, and the biomechanical properties of the femoral diaphysis reflecting cortical bone strength.
Reduced expression of ATF4 in global ATF4-haplodeficient and SMC-specific <i>Atf4</i> KO mice reduced medial and atherosclerotic calcification under normal kidney and CKD conditions.