title: Relationship of fetuin-A with glomerular filtration rate and endothelial dysfunction in moderate-severe chronic kidney disease.
abstract: BACKGROUND
  In end-stage renal disease, fetuin-A has been demonstrated to be reduced and inversely related to cardiovascular mortality. This study had 2 distinct aims. The first was to verify if circulating concentration of fetuin-A may depend on renal function in patients with chronic kidney disease (CKD). Furthermore, we analyzed the correlation of fetuin-A with the biomarker of endothelial dysfunction endothelin-1 (ET-1), and with the inflammatory cytokine interleukin-6 (IL-6).
  
  
  METHODS
  In 108 subjects with stage 3-5 CKD, plasma levels of fetuin-A, ET-1 and IL-6 were assayed. Patients were studied first as a whole group and then were divided according to stages of CKD and fetuin-A tertiles.
  
  
  RESULTS
  Fetuin-A concentration decreased in parallel with the increase in ET-1 and IL-6 levels as renal function declined. Multiple regression analysis showed that fetuin-A was independently associated with estimated glomerular filtration rate (beta=0.386; p<0.001), IL-6 (beta=-0.393; p=0.001) and ET-1 (beta=-0.219; p=0.02), in a multivariate model including also sex, parathyroid hormone and the calcium x phosphorus product.
  
  
  CONCLUSIONS
  These results seem to indicate that in CKD, even when not severe, inflammatory processes are increased and linked to endothelial dysfunction, worsening progressively with the decline of renal function.
authors.affiliation: Department of Internal Medicine, University of Palermo, Palermo, Italy. sancott@tin.it
authors.forename: Santina
authors.initials: S
authors.lastname: Cottone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Palermo
authors.forename: Rosalia
authors.initials: R
authors.lastname: Arsena
authors.forename: Raffella
authors.initials: R
authors.lastname: Riccobene
authors.forename: Marco
authors.initials: M
authors.lastname: Guarneri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mulè
authors.forename: Francesca
authors.initials: F
authors.lastname: Tornese
authors.forename: Chiara
authors.initials: C
authors.lastname: Altieri
authors.forename: Francesco
authors.initials: F
authors.lastname: Vaccaro
authors.forename: Antonino
authors.initials: A
authors.lastname: Previti
authors.forename: Antonio
authors.initials: A
authors.lastname: Previti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cerasola
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000378:metabolism*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007674:Kidney Diseases / Q000097:blood / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012720:Severity of Illness Index; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D015415:Biomarkers; D001798:Blood Proteins; D019332:Endothelin-1; D015850:Interleukin-6; D010281:Parathyroid Hormone; D060749:alpha-2-HS-Glycoprotein