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Sclerostin as a new key factor in vascular calcification in chronic kidney disease stages 3 and 4

International Urology and Nephrology volume 48, pages 2043–2050 (2016)Cite this article

Abstract

Background

Sclerostin is an osteocyte-derived inhibitor of the Wnt pathway and has been shown to play a key role in chronic kidney disease-mineral and bone disorder (CKD-MBD). The present study aimed to validate its potential as a predictor of vascular calcification in patients with CKD stages 3–4.

Methods

A total of 97 patients with CKD stages 3–4 were enrolled in this cross-sectional study. Routine clinical biochemistry tests and assays for sclerostin and mineral metabolism markers were performed. Additionally, vascular calcification was assessed by multislice spiral computed tomography. Logistic regression analyses were used to study the relationships between sclerostin and vascular calcification.

Results

Serum sclerostin levels (30.8 ± 6.4 vs. 41.7 ± 12.6 pmol/L, P < 0.05) were significantly elevated in patients with CKD stage 3a compared to in controls and increased with the decline in glomerular filtration rates. Furthermore, patients with vascular calcification had higher serum sclerostin levels. Patients with sclerostin levels above the median value had increased the prevalence of vascular calcification. Multivariate analysis revealed that sclerostin levels were positively associated with vascular calcification.

Conclusion

Our data indicate that sclerostin levels are elevated in patients with CKD and are associated with vascular calcification. Therefore, sclerostin may be used as a predictor of vascular calcification in the clinical setting.

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Abbreviations

CKD:

Chronic kidney disease

CVD:

Cardiovascular disease

CKD-MBD:

Chronic kidney disease-mineral bone disorder

ALP:

Alkaline phosphatase

PTH:

Parathyroid hormone

FGF23:

Fibroblast growth factor-23

KDIGO:

Kidney Disease: Improving Global Outcomes

eGFR:

Estimated glomerular filtration rates

MDRD:

Modification of Diet in Renal Disease equation

SCr:

Creatinine

CRP:

C-reactive protein

iPTH:

Intact PTH

ECLIA:

Electrochemiluminescence immunoassay

ELISA:

Enzyme-linked immunosorbent assay

CVs:

Coefficients of variation

CT:

Nonenhanced computed tomography

SEM:

Standard error of the mean

BMI:

Body mass index

HDL:

High-density lipoprotein

LDL:

Low-density lipoprotein

ND-CKD:

Nondialysis chronic kidney disease

CAC:

Coronary artery calcification

VSMCs:

Vascular smooth muscle cells

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Acknowledgments

This work was funded by Promotive Research Fund for Science and Technology Development Plan Project of Yantai, Shandong Province (2016), and was supported by National Natural Science Foundation of China (81302234).

Author information

Affiliations

  1. Department of Nephrology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, China

    Wei Lv, Yan Zhang & Yongqiang Ji

  2. Neurological Intensive Care Unit, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, China

    Lina Guan

  3. Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, China

    Shengqiang Yu

  4. Medical Imaging Center, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, China

    Bofeng Cao

Authors
  1. Wei Lv
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  2. Lina Guan
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  3. Yan Zhang
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  4. Shengqiang Yu
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  5. Bofeng Cao
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Corresponding author

Correspondence to Yan Zhang.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical standard

This study was conducted in accordance with the Declaration of Helsinki. All of the participants provided written informed consent for the protocol, which was approved by the Ethics Committee of Yuhuangding Hospital.

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Cite this article

Lv, W., Guan, L., Zhang, Y. et al. Sclerostin as a new key factor in vascular calcification in chronic kidney disease stages 3 and 4. Int Urol Nephrol 48, 2043–2050 (2016). https://doi.org/10.1007/s11255-016-1379-8

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  • DOI: https://doi.org/10.1007/s11255-016-1379-8

Keywords

  • Chronic kidney disease
  • Vascular calcification
  • Sclerostin