Association of serum fetuin-A levels with mortality in dialysis patients.
Calcifying atherosclerosis is an active process, which is controlled by calcification inhibitors and inducers. Fetuin-A, an acute phase glycoprotein, is one of the more powerful circulating inhibitors of hydroxyapatite formation. A prospective multicenter cohort study was initiated to include both hemodialysis (HD) and peritoneal dialysis (PD) patients in an evaluation of the association of serum fetuin-A levels with both cardiovascular (CV) and non-CV mortality. An increase in the serum fetuin-A concentration of 0.1 g/l was associated with a significant reduction in all-cause mortality of 13%. There was a significant 17% reduction in non-CV mortality and a near significant reduction in CV mortality. This association of fetuin-A and mortality rates was comparable in both HD and PD patients even when corrected for factors, including but not limited to age, gender, primary kidney disease, C-reactive protein levels, and nutritional status. We conclude that serum fetuin-A concentrations may be a general predictor of mortality in dialysis patients.
Hermans
M M H
MM
Department of Internal Medicine and Nephrology, Academic Hospital Maastricht, Maastricht, The Netherlands. mherm@sint.azm.nl
Brandenburg
V
V
Ketteler
M
M
Kooman
J P
JP
van der Sande
F M
FM
Boeschoten
E W
EW
Leunissen
K M L
KM
Krediet
R T
RT
Dekker
F W
FW
D000368:Aged; D002318:Cardiovascular Diseases; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010530:Peritoneal Dialysis / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D016019:Survival Analysis; D000509:alpha-Fetoproteins / Q000032:analysis*
D000509:alpha-Fetoproteins