TNFRSF11B and chronic kidney disease: Extensive studies on the occurrence of VC show that systemic or local inhibitory factors, such as matrix Gla protein, fetuin-A, osteopontin, osteoprotegerin, and pyrophosphate, are most likely overwhelmed in CKD patients by promoters (calcium and phosphate abnormalities, extreme serum PTH levels, excess administration of calcium salts, inflammation, malnutrition, and oxidative stress) that induce vascular smooth muscle cell damage and death.