title: Factors associated with serum fetuin-A concentrations after long-term use of different phosphate binders in hemodialysis patients.
abstract: BACKGROUND
  Fetuin-A is known as a circulating inhibitor of vascular calcification. Factors associated with serum fetuin-A concentrations after long-term use of different phosphate binders in hemodialysis patients is still uncertain.
  
  
  METHODS
  In the post-hoc study, we analyzed serum fetuin-A and biochemical factors (Ca, P, i-PTH, hsCRP, TG, LDL-C) in 50 hemodialysis patients, who completed a 48-week, open-Label, controlled randomized parallel-group study. 23 patients received sevelamer and 27 patients received calcium carbonate.
  
  
  RESULTS
  After the 48-week treatment, the sevelamer group had less serum calcium increment, less iPTH decrement, more ALK-P increment, more hsCRP decrement and more LDL-C decrement. There was no significant difference in the serum fetuin-A decrement between two groups. Decreased serum fetuin-A levels were found after 48-week treatment in both groups: from 210.61 (104.73) to 153.85 (38.64) ug/dl, P = 0.003 in sevelamer group, from 203.95 (107.87) to 170.90 (58.02) ug/mL, P =0.002 in calcium group. The decrement in serum fetuin-A (Δfetuin-A) levels was associated with ΔCa (ρ = - 0.230, P = 0.040), ΔiPTH (ρ = 0.306, P = 0.031) and Δalbumin (ρ = 0.408, P = 0.003), not associated with sevelamer use, ΔP and ΔhsCRP.
  
  
  CONCLUSIONS
  After long-term sevelamer or calcium carbonate treatment, both groups of maintenance HD patients had lower serum fetuin-A levels. Serum levels of increased calcium, decreased iPTH and decreased albumin were associated with the serum fetuin-A decrement.
authors.affiliation: The Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.affiliation: Hsin-Jen Hospital, Taipei, Taiwan.
authors.forename: Hung-Hsiang
authors.initials: HH
authors.lastname: Liou
authors.affiliation: Division of Nephrology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ming-Shiou
authors.initials: MS
authors.lastname: Wu
authors.affiliation: The Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung, Taiwan. cch@mail.cmuh.org.tw.|Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan. cch@mail.cmuh.org.tw.
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D002119:Calcium Carbonate / Q000627:therapeutic use*; D002614:Chelating Agents / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000378:metabolism; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000150:complications / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D010758:Phosphorus / Q000378:metabolism; D006435:Renal Dialysis / Q000379:methods*; D000069603:Sevelamer / Q000627:therapeutic use*; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: C556354:AHSG protein, human; D002614:Chelating Agents; D008078:Cholesterol, LDL; D010281:Parathyroid Hormone; D014280:Triglycerides; D060749:alpha-2-HS-Glycoprotein; D010758:Phosphorus; D002097:C-Reactive Protein; D000069603:Sevelamer; D002119:Calcium Carbonate; D002118:Calcium
keywords: CKD; ESRD; Fetuin-A; Hemodialysis; Phosphate binder; Sevelamer