title: Association of serum fetuin-A levels with mortality in dialysis patients.
abstract: 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.
authors.affiliation: Department of Internal Medicine and Nephrology, Academic Hospital Maastricht, Maastricht, The Netherlands. mherm@sint.azm.nl
authors.forename: M M H
authors.initials: MM
authors.lastname: Hermans
authors.forename: V
authors.initials: V
authors.lastname: Brandenburg
authors.forename: M
authors.initials: M
authors.lastname: Ketteler
authors.forename: J P
authors.initials: JP
authors.lastname: Kooman
authors.forename: F M
authors.initials: FM
authors.lastname: van der Sande
authors.forename: E W
authors.initials: EW
authors.lastname: Boeschoten
authors.forename: K M L
authors.initials: KM
authors.lastname: Leunissen
authors.forename: R T
authors.initials: RT
authors.lastname: Krediet
authors.forename: F W
authors.initials: FW
authors.lastname: Dekker
mesh_terms: 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*
chemical_list: D000509:alpha-Fetoproteins