The high incidence of vascular calcification (VC) in patients with chronic kidney disease (CKD) has become an important clinical subject. Hyperphosphatemia is a primary cause of CKD-related VC. Intravenous iron sucrose (IS) is commonly used to treat anemia in CKD patients, and is effective and well tolerated worldwide. However, the interaction between iron and VC remains controversial, and the underlying mechanisms are yet to be clarified. In the present study, ex vivo normal rat aortic rings were cultured with various concentrations of phosphate and IS, and the levels of calcium and iron depositions, oxidative injury, as well as phenotypic marker genes were detected. To the best of our knowledge, the present study is the first to report that IS is a double-edged sword in high phosphate media-induced VC which not only alleviates VC in a dose-dependent manner but also leads to iron overload in vasculature when in high concentration. IS is a promising agent for VC prevention in patients with hyperphosphatemia and iron deficiency. Meanwhile, the appropriate blood concentration of IS in patients with hyperphosphatemia needs to be explored clinically.

慢性肾脏病（CKD）患者血管钙化（VC）的高发已成为临床的重要课题。高磷血症是 CKD 相关 VC 的主要原因。静脉注射蔗糖铁 (IS) 常用于治疗 CKD 患者的贫血，在全球范围内有效且耐受性良好。然而，铁与VC之间的相互作用仍存在争议，其潜在机制仍有待阐明。在本研究中，体外正常大鼠主动脉环与不同浓度的磷酸盐和 IS 一起培养，并检测钙和铁沉积、氧化损伤以及表型标记基因的水平。据我们所知，本研究首次报道，IS 在高磷酸盐介质诱导的 VC 中是一把双刃剑，它不仅以剂量依赖性方式减轻 VC，而且在高浓度时会导致脉管系统铁过载。IS 是预防高磷血症和缺铁患者 VC 的有前景的药物。同时，临床上还需要探索高磷血症患者适当的IS血药浓度。