My research investigates the relationship of kidney disease, vascular calcification, bone, and disorders of mineral metabolism known as CKD-Mineral Bone Disorder (CKD-MBD). Our research is funded by the NIH, Veterans Administration, Food and Drug Administration, and industry and utilizes in vivo, ex vivo and in vitro techniques to investigate the pathophysiology of arterial medial calcification and bone disease. We are using a naturally occurring rat model of CKD that spontaneously develops all manifestations of CKD-MBD to study 1) mechanisms by which matrix vesicles propagate arterial calcification, 2) how oxidative stress alters vasculature, 3) the role of advanced glycation end product cross linking of bone collagen predisposes to fracture, 4) mechanisms of sudden cardiac death, 5) how impaired muscle function occurs with progressive CKD, and 6) micro RNA as biomarkers. We also have active investigator initiated clinical trials studying the natural progression of frailty and muscle weakness in patients as they start on dialysis, novel phosphate binders and the effect on phosphate balance, how nutrition can be enhanced in patients on dialysis, and the use of pioglitazone as a treatment for ADPKD.