Sharon M. Moe, MD

Division Director

Stuart Kleit Professor of Medicine

PubMed Listing

Research Interests:

My research investigates the relationship of kidney disease, vascular calcification, bone, and disorders of mineral metabolism. Our research has utilized in vivo, ex vivo and in vitro techniques to investigate the pathophysiology of arterial medial calcification. We have found in arteries from patients undergoing a kidney transplant that vascular smooth muscle cells express a transcription factor Cbfa1 (Runx2) that is critical for bone formation. The presence of this factor, and several downstream proteins, in arteries that are calcified in CKD patients confirms that the calcification is an active, cell mediated process. We have also found that uremic serum isolated from dialysis patients upregulates Cbfa1 in cultured vascular smooth muscle cells, and accelerates calcification in vitro. We are now investigating this pathway using a naturally occurring rat model of CKD and arterial calcification. We are also evaluating various dietary and drug treatments in this animal model.

In addition to the evaluation of factors that increase calcification, we are also investigating the role of inhibitors of calcification, specifically focusing on fetuin-A, a reverse acute phase protein. Fetuin-A levels are low in inflammatory states such as CKD, and we have found low levels are correlated with increased arterial calcification in dialysis patients. Fetuin-A appears to inhibit calcification by multiple mechanisms, and may regulate changes in intracellular calcium that are needed for the initiation of calcification.

We also have several ongoing clinical trials that evaluate new therapies for patients with bone and mineral disorders in kidney disease, including vitamin D, phosphate binders, and calcimimetics.