Elevated osteoprotegerin levels predict cardiovascular events in new hemodialysis patients.
BACKGROUND
Patients on hemodialysis (HD) frequently experience cardiovascular events associated with vascular calcification. We investigated the involvement of osteoprotegerin (OPG), an inhibitor of vascular calcification, in the incidence of cardiovascular events and mortality among new HD patients.


METHODS
We conducted a prospective cohort study of the association of serum OPG levels with morbidity and mortality in subjects who became new HD patients between June 2000 and May 2006.


RESULTS
A total of 99 patients (age 58.9 +/- 14.6 years, 65 male, 34 female) were prospectively followed up for 41.5 +/- 20.2 months. During this period, 27 patients developed cardiovascular events and 12 died of causes related to cardiovascular disease. When divided into 2 groups according to OPG levels, the high OPG group showed a higher prevalence of cardiovascular morbidity and mortality compared with the low OPG group. Cox's proportional hazards analysis associated the new onset of cardiovascular events with the high OPG group (HR 2.88, 95% CI 1.09-7.62, p = 0.033). Furthermore, the high OPG group at the start of HD was significantly associated with older age, male gender and a high aortic calcification index.


CONCLUSIONS
Elevated levels of serum OPG in new HD patients may predict subsequent cardiovascular events.
Nishiura
Ryosuke
R
Division of Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Fujimoto
Shouichi
S
Sato
Yuji
Y
Yamada
Kazuhiro
K
Hisanaga
Shuichi
S
Hara
Seiichiro
S
Nakao
Hiroyuki
H
Kitamura
Kazuo
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000097:blood* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D055815:Young Adult
D053244:Osteoprotegerin