title: Elevated levels of plasma osteoprotegerin are associated with all-cause mortality risk and atherosclerosis in patients with stages 3 to 5 chronic kidney disease.
abstract: Osteoprotegerin (OPG) regulates bone mass by inhibiting osteoclast differentiation and activation, and plays a role in vascular calcification. We evaluated the relationship between osteoprotegerin levels and inflammatory markers, atherosclerosis, and mortality in patients with stages 3-5 chronic kidney disease. A total of 145 subjects (median age 61 years, 61% men; 36 patients on hemodialysis, 55 patients on peritoneal dialysis, and 54 patients with stages 3-5 chronic kidney disease) were studied. Clinical characteristics, markers of mineral metabolism (including fibroblast growth factor-23 [FGF-23]) and inflammation (high-sensitivity C-reactive protein [hsCRP] and interleukin-6 [IL-6]), and the intima-media thickness (IMT) in the common carotid arteries were measured at baseline. Cardiac function was assessed by color tissue Doppler echocardiography. After 36 months follow-up, the survival rate by Kaplan-Meier analysis was significantly different according to OPG levels (χ ² =14.33; P=0.002). Increased OPG levels were positively associated with IL-6 (r=0.38, P<0.001), FGF-23 (r=0.26, P<0.001) and hsCRP (r=0.0.24, P=0.003). In addition, OPG was positively associated with troponin I (r=0.54, P<0.001) and IMT (r=0.39, P<0.0001). Finally, in Cox analysis, only OPG (HR=1.07, 95%CI=1.02-1.13) and hsCRP (HR=1.02, 95%CI=1.01-1.04) were independently associated with increased risk of death. These results suggested that elevated levels of serum OPG might be associated with atherosclerosis and all-cause mortality in patients with chronic kidney disease.
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden.
authors.forename: M M
authors.initials: MM
authors.lastname: Nascimento
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden.
authors.forename: S Y
authors.initials: SY
authors.lastname: Hayashi
authors.affiliation: Serviço de Nefrologia, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brasil.
authors.forename: M C
authors.initials: MC
authors.lastname: Riella
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Lindholm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D059168:Carotid Intima-Media Thickness; D002423:Cause of Death; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000032:analysis; D006334:Heart Function Tests; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053244:Osteoprotegerin / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000401:mortality*; D012306:Risk; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D015850:Interleukin-6; D053244:Osteoprotegerin; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002097:C-Reactive Protein