title: The progression of vascular calcification and serum osteoprotegerin levels in patients on long-term hemodialysis.
abstract: BACKGROUND
  The aortic calcification index (ACI), estimated on abdominal computed tomographic scans, has been associated with the extent of arteriosclerosis in hemodialysis patients. However, the contribution of biochemical markers to the progression of vascular calcification in patients undergoing hemodialysis is not fully understood.
  
  
  METHODS
  We examined the relationship between coronary risk factors; metabolic factors, including serum osteoprotegerin (OPG) concentration; and progression of vascular calcification in 26 dialysis patients.
  
  
  RESULTS
  Mean patient age was 52.6 +/- 8.7 (SD) years, and mean duration of dialysis therapy was 7.7 +/- 5.8 years. ACI was measured twice in each patient, and the mean interscan period was 4.9 +/- 0.3 years. Mean ACI changed from 22.2 +/- 24.2 to 33.9 +/- 28.8 overall, and mean change in ACI (DeltaACI) was 12.0 +/- 9.9. Patients were divided into 2 groups: slow progressors, with DeltaACI of 4.1 +/- 3.2 (n = 13), and rapid progressors, with DeltaACI of 19.8 +/- 7.9 (n = 13). Serum fasting glucose and CRP levels of rapid progressors were high, and their serum albumin and intact parathyroid hormone levels were low. Multiple regression analyses showed that serum OPG levels were independently associated with vascular calcification in the hemodialysis patients studied.
  
  
  CONCLUSIONS
  Rapid progression of vascular calcification was associated with dose of calcium carbonate prescribed and serum OPG concentration. The clinical significance of these observations remains to be determined.
authors.affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan. nitta@kc.twmu.ac.jp
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiba
authors.forename: Keiko
authors.initials: K
authors.lastname: Uchida
authors.forename: Akira
authors.initials: A
authors.lastname: Kawashima
authors.forename: Wako
authors.initials: W
authors.lastname: Yumura
authors.forename: Takashi
authors.initials: T
authors.lastname: Kabaya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nihei
mesh_terms: D001018:Aortic Diseases / Q000097:blood / Q000209:etiology*; D001161:Arteriosclerosis / Q000097:blood / Q000209:etiology*; D002097:C-Reactive Protein / Q000032:analysis; D002114:Calcinosis / Q000097:blood / Q000209:etiology*; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate / Q000008:administration & dosage / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D018160:Receptors, Cytoplasmic and Nuclear / Q000097:blood*; D018124:Receptors, Tumor Necrosis Factor; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors
chemical_list: D006023:Glycoproteins; D008055:Lipids; D053244:Osteoprotegerin; D010281:Parathyroid Hormone; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C506030:TNFRSF11B protein, human; D010758:Phosphorus; D002097:C-Reactive Protein; D002119:Calcium Carbonate; D002118:Calcium