title: Serum sclerostin is an independent predictor of mortality in hemodialysis patients.
abstract: BACKGROUND
  Sclerostin (Scl) has recently emerged as a novel marker of bone remodeling and vascular calcification. However, whether high circulating Scl is also a risk factor for death is not well established. The purpose of this study was to test whether serum Scl would be associated with mortality.
  
  
  METHODS
  we measured serum Scl in a hemodialysis patients' cohort, which was followed during a ten-year period. Competing risk regression models were applied, as during the follow-up, patients were exposed to both events kidney transplant and death.
  
  
  RESULTS
  Ninety-one patients aged 42.3±18.8 years (55% of male gender, 15% of diabetes) were included. During the follow-up, 32 patients underwent kidney transplant and 26 patients died. Non-survivals presented higher FGF23, higher Scl and lower creatinine. There was an association between all-cause mortality and higher Scl (HR=2.2), higher age (HR=1.04) and presence of diabetes (HR=2.27), by competing risk analyses. Even including potential markers of mortality, as creatinine, FGF 23, and gender, Scl, age and diabetes remained significantly related to higher mortality.
  
  
  CONCLUSIONS
  Serum Scl is an independent predictor of mortality in dialysis patients. However, whether clinical interventions to modulate Scl would be able to improve these patients survival needs to be determined.
authors.forename: Flávia Letícia Carvalho
authors.initials: FL
authors.lastname: Gonçalves
authors.forename: Rosilene M
authors.initials: RM
authors.lastname: Elias
authors.forename: Luciene M
authors.initials: LM
authors.lastname: dos Reis
authors.forename: Fabiana G
authors.initials: FG
authors.lastname: Graciolli
authors.forename: Fernando Godinho
authors.initials: FG
authors.lastname: Zampieri
authors.forename: Rodrigo B
authors.initials: RB
authors.lastname: Oliveira
authors.forename: Vanda
authors.initials: V
authors.lastname: Jorgetti
authors.affiliation: Nephrology Division, Universidade de São Paulo, São Paulo, Brazil. rosa.moyses@uol.com.br.
authors.forename: Rosa M A
authors.initials: RM
authors.lastname: Moysés
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D005500:Follow-Up Studies; D005819:Genetic Markers; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; C000717427:FGF23 protein, human; D005819:Genetic Markers; C422903:SOST protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D003404:Creatinine