title: Fetuin-A, coronary artery calcification and outcome in maintenance hemodialysis patients.
abstract: OBJECTIVE
  Previous studies have suggested that serum fetuin-A, a calcification inhibitor, predicts mortality in dialysis patients. This study investigated the relationships between fetuin-A, vascular calcification, and outcome in such patients.
  
  
  METHODS
  58 patients on maintenance hemodialysis underwent multirow spiral computed tomography to determine baseline coronary artery calcification (CAC) score. Serum fetuin-A was measured repeatedly over time.
  
  
  RESULTS
  Time-averaged fetuin-A inversely correlated with age and baseline CAC score. After partial correlation analysis controlling for age, the association between fetuin-A and CAC became insignificant. During the study, 27 of 58 patients died and 26 experienced at least one cardiovascular event. Low fetuin-A was associated with a significant increase in all-cause mortality and the occurrence of a cardiovascular event. The association of fetuin-A with mortality and cardiovascular event remained significant even when adjusting for confounding factors, including age and CAC score.
  
  
  CONCLUSIONS
  Time-averaged fetuin-A was associated with survival and cardiovascular outcome, independent of vascular calcification.
authors.affiliation: Department of Internal Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, South Korea. haehyuk@kangwon.ac.kr
authors.forename: H H
authors.initials: HH
authors.lastname: Jung
authors.forename: H J
authors.initials: HJ
authors.lastname: Baek
authors.forename: S-W
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001798:Blood Proteins / Q000032:analysis / Q000502:physiology*; D002114:Calcinosis / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000401:mortality; D003324:Coronary Artery Disease / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein