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Sclerostin, an inhibitor of the Wnt signaling pathway, inhibits bone formation. In a study of vascular biopsies of patients undergoing kidney transplantation, Qureshi et al. demonstrate that circulating sclerostin levels are associated with vascular calcification (VC). This adds to an emerging body of literature implicating sclerostin as a key link between chronic kidney disease–mineral and bone disorder and cardiovascular disease. Some confounders of this association remain, and the mechanisms by which sclerostin promotes VC have yet to be elucidated.