Relationship of fetuin-A with glomerular filtration rate and endothelial dysfunction in moderate-severe chronic kidney disease.
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.
Cottone
Santina
S
Department of Internal Medicine, University of Palermo, Palermo, Italy. sancott@tin.it
Palermo
Alessandro
A
Arsena
Rosalia
R
Riccobene
Raffella
R
Guarneri
Marco
M
Mulè
Giuseppe
G
Tornese
Francesca
F
Altieri
Chiara
C
Vaccaro
Francesco
F
Previti
Antonino
A
Previti
Antonio
A
Cerasola
Giovanni
G
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
C556354:AHSG protein, human; D015415:Biomarkers; D001798:Blood Proteins; D019332:Endothelin-1; D015850:Interleukin-6; D010281:Parathyroid Hormone; D060749:alpha-2-HS-Glycoprotein