Fetuin-A is an independent determinant of change of aortic stiffness over 1 year in non-diabetic patients with CKD stages 3 and 4.
BACKGROUND
Vascular calcification is highly prevalent in chronic kidney disease (CKD) patients. This calcification leads to arterial stiffening. Fetuin-A is an endogenous inhibitor of vascular calcification and has been associated with arterial stiffness and mortality in dialysis patients. We tested the relationship between fetuin-A and change in arterial stiffness in CKD stages 3 and 4.


METHODS
We measured fetuin-A concentrations in 92 patients with CKD stages 3 and 4 and studied the association with clinical, biochemical and vascular parameters including arterial stiffness measured by carotid-femoral pulse wave velocity (PWV) at 0 and 12 months.


RESULTS
Fetuin-A was significantly lower in the non-diabetic group (n = 73) compared to the diabetic group (n = 19, P = 0.018). There was a significant interaction between diabetic status and fetuin-A concentration. Univariate analysis of the non-diabetic group showed association between change in aortic stiffness over 1 year with fetuin-A (r = -0.481, P < 0.0001) and systolic blood pressure (r = 0.389, P = 0.001) and baseline PWV (r = 0.240, P = 0.041). In multivariate analysis, fetuin-A, systolic blood pressure and baseline PWV independently predicted change in carotid-femoral PWV at 1 year (beta = -0.355, P = or< 0.001; beta = 0.426, P < 0.001; and beta = -0.383, P < 0.001, respectively; model R(2) = 0.455).


CONCLUSIONS
In patients with non-diabetic CKD stages 3 and 4, fetuin-A is an independent risk factor for progressive arterial stiffness.
Ford
Martin L
ML
Brighton and Sussex Medical School, Audrey Emerton Building, Eastern Road, Brighton, BN2 5BE, UK. martin.ford@bsuh.nhs.uk
Tomlinson
Laurie A
LA
Smith
Edward R
ER
Rajkumar
Chakravarthi
C
Holt
Stephen G
SG
D000368:Aged; D001011:Aorta / Q000473:pathology / Q000503:physiopathology*; D001794:Blood Pressure; D001798:Blood Proteins / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000473:pathology / Q000503:physiopathology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011673:Pulsatile Flow; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000145:classification / Q000473:pathology / Q000503:physiopathology*; D012307:Risk Factors; D013997:Time Factors; D014655:Vascular Resistance; D060749:alpha-2-HS-Glycoprotein
C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein; D002097:C-Reactive Protein