Dalfino et al. (2010) and Rong et al. (2014) proposed that in late-stage CKD patients, the serum levels of BMP2 increase, and extracellular high Pi along with BMP2 can upregulate the expression of osteogenic transcription factors MSX2 and RUNX2 in VSMCs, promoting their transdifferentiation into osteoblast-like cells. This process found that β-catenin protein links high Pi, BMP2, and the WNT/β-catenin signaling pathway in the regulation of VC as a whole (Dalfino et al., 2010; Rong et al., 2014). Here, MSX2 is linked to chronic kidney disease.