Skip to main content

Advertisement

Log in

Vascular calcification is not related to serum fetuin-A and osteopontin levels in hemodialysis patients

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Introduction

Vascular calcification (VC) in hemodialysis (HD) patients is a sign of severe cardiovascular disease and can predict cardiovascular outcomes. Fetuin-A and osteopontin (OPN) inhibit VC. Serum fetuin-A levels are lower in patients with end-stage kidney disease (ESKD) and in those who are on chronic HD therapy. However, there are limited data concerning OPN in patients who are on dialysis. The aim of our study was to determine VC in HD patients, the relationship between VC and 25-OH-vitamin D, fetuin-A, and OPN levels, and independent predictors of VC.

Materials and methods

Ninety-three patients with ESKD on HD therapy were recruited. Among these patients, 44 were male and 49 were female. The patient group was compared with a group of 20 healthy controls of similar age and sex. A plain radiograph of the hand was taken using a mammography machine for the evaluation of VC. Serum fetuin-A, OPN, and 25-OH-vitamin D levels of both patients and controls were measured.

Results

VC was detected in 45 (48.4%) HD patients. When patients were compared with healthy controls, fetuin-A levels (p < 0.029) were significantly lower in patients, whereas OPN (p < 0.000) and VC (p < 0.002) were significantly higher in the patient group. Age [odds ratio (OR) 1.036], the presence of diabetes mellitus (DM) (OR 17.527), and high parathyroid hormone (PTH) levels (OR 1.002) were independent predictors of VC in a logistic regression model including the following factors: age, the presence of DM, HD duration, and serum albumin, phosphate, PTH, 25-OH-vitamin D, fetuin-A, OPN, and calcium levels. No significant correlation was found between patients with VC and patients without VC in terms of fetuin-A, OPN, and 25-OH-vitamin D levels.

Conclusions

VC is a frequent sign in patients undergoing HD and is not related to serum fetuin-A and osteopontin levels. Age, the presence of DM, and high PTH levels were independent predictors of VC in patients undergoing HD. Further studies are warranted to understand the mechanism underlying and the factors contributing to VC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. National Kidney foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266

    Google Scholar 

  2. Collins AJ, Kasiske B, Herzog C, Chen SC, Everson S, Constantini E, Grimm R, McBean M, Xue J, Chavers B, Matas A, Manning W, Louis T, Pan W, Liu J, Li S, Roberts T, Dalleska F, Snyder J, Ebben J, Frazier E, Sheets D, Johnson R, Li S, Dunning S, Berrini D, Guo H, Solid C, Arko C, Daniels F, Wang X, Forrest B, Gilbertson D, St Peter W, Frederick P, Eggers P, Agodoa L (2003) Excerpts from the United States Renal Data System 2003 annual data report: atlas of end-stage renal disease in the United States. Am J Kidney Dis 42(6 Suppl 5):A5–A7, S1–S230

    PubMed  Google Scholar 

  3. Demer LL (1995) A skeleton in the atherosclerosis closet. Circulation 92:2029–2032

    Article  CAS  PubMed  Google Scholar 

  4. Bostrom K, Watson KE, Horn S, Wortham C, Herman IM, Demer LL (1993) Bone morphogenetic protein expression in human atherosclerotic lesions. J Clin Invest 91:1800–1809

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Shlipak MG, Heidenreich PA, Noguchi H et al (2002) Association of renal insufficiency with treatment and outcomes after myocardial infarction in elderly patients. Ann Intern Med 137:555–562

    Article  PubMed  Google Scholar 

  6. Wright RS, Reeder GS, Herzog CA et al (2002) Acute myocardial infarction and renal dysfunction: a high-risk combination. Ann Intern Med 137:563–570

    Article  PubMed  Google Scholar 

  7. Keough-Ryan T, Hutchinson T, MacGibbon B, Senecal M (2002) Studies of prognostic factors in end-stage renal disease: an epidemiological statistical critique. Am J Kidney Dis 39:1196–1205

    Article  PubMed  Google Scholar 

  8. London GM, Guérin AP, Marchais SJ, Métivier F, Pannier B, Adda H (2003) Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 18(9):1731–1740

    Article  PubMed  Google Scholar 

  9. Moe SM, Reslerova M, Ketteler M, O’Neill K, Duan D, Koczman J, Westenfeld R, Jahnen-Dechent W, Chen NX (2005) Role of calcification inhibitors in the pathogenesis of vascular calcification in chronic kidney disease (CKD). Kidney Int 67:2295–2304

    Article  CAS  PubMed  Google Scholar 

  10. Cozzolino M, Galassi A, Biondi ML, Turri O, Papagni S, Mongelli N, Civita L, Gallieni M, Brancaccio D (2006) Serum fetuin-A levels link inflammation and cardiovascular calcification in hemodialysis patients. Am J Nephrol 26:423–429

    Article  CAS  PubMed  Google Scholar 

  11. Russo D, Corrao S, Miranda I, Ruocco C, Manzi S, Elefante R, Brancaccio D, Cozzolino M, Biondi ML, Andreucci VE (2007) Progression of coronary artery calcification in predialysis patients. Am J Nephrol 27:152–158

    Article  PubMed  Google Scholar 

  12. Zheng S, de Las Fuentes L, Bierhals A, Ash-Bernal R, Spence K, Slatopolsky E, Davila-Roman VG, Delmez J (2009) Relation of serum fetuin-A levels to coronary artery calcium in African–American patients on chronic hemodialysis. Am J Cardiol 103:46–49

    Article  CAS  PubMed  Google Scholar 

  13. Mikami S, Hamano T, Fujii N, Nagasawa Y, Isaka Y, Moriyama T, Matsuhisa M, Ito T, Imai E, Hori M (2008) Serum osteoprotegerin as a screening tool for coronary artery calcification score in diabetic pre-dialysis patients. Hypertens Res 31:1163–1170

    Article  CAS  PubMed  Google Scholar 

  14. Jung HH, Kim SW, Han H (2006) Inflammation, mineral metabolism and progressive coronary artery calcification in patients on haemodialysis. Nephrol Dial Transplant 21:1915–1920

    Article  CAS  PubMed  Google Scholar 

  15. Herrmann SM, Whatling C, Brand E, Nicaud V, Gariepy J, Simon A, Evans A, Ruidavets JB, Arveiler D, Luc G, Tiret L, Henney A, Cambien F (2000) Polymorphisms of the human matrix gla protein (MGP) gene, vascular calcification, and myocardial infarction. Arterioscler Thromb Vasc Biol 20:2386–2393

    Article  CAS  PubMed  Google Scholar 

  16. Miyauchi A, Alvarez J, Greenfield EM, Teti A, Grano M, Colucci S, Zambonin-Zallone A, Ross FP, Teitelbaum SL, Cheresh D et al (1991) Recognition of osteopontin and related peptides by an alpha v beta 3 integrin stimulates immediate cell signals in osteoclasts. J Biol Chem 266:20369–20374

    CAS  PubMed  Google Scholar 

  17. Steitz SA, Speer MY, McKee MD, Liaw L, Almeida M, Yang H, Giachelli CM (2002) Osteopontin inhibits mineral deposition and promotes regression of ectopic calcification. Am J Pathol 161:2035–2046

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Wada T, McKee MD, Steitz S, Giachelli CM (1999) Calcification of vascular smooth muscle cell cultures: inhibition by osteopontin. Circ Res 84:166–178

    Article  CAS  PubMed  Google Scholar 

  19. Lee CT, Chua S, Hsu CY, Tsai YC, Ng HY, Kuo CC, Wu CH, Chen TC, Chiu TT, Lee YT (2013) Biomarkers associated with vascular and valvular calcification in chronic hemodialysis patients. Dis Markers 34(4):229–235

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Ramirez-Sandoval JC, Casanova I, Villar A, Gomez FE, Cruz C, Correa-Rotter R (2016) Biomarkers associated with vascular calcification in peritoneal dialysis. Perit Dial Int 36(3):262–268. https://doi.org/10.3747/pdi.2014.00250 (Epub 2015 Aug 20)

    Article  CAS  PubMed  Google Scholar 

  21. Barreto DV, Lenglet A, Liabeuf S, Kretschmer A, Barreto FC, Nollet A, Slama M, Choukroun G, Brazier M, Massy Z (2011) Prognostic implication of plasma osteopontin levels in patients with chronic kidney disease. Nephron Clin Pract 117(4):c363–c372. https://doi.org/10.1159/000321520 (Epub 2010 Nov 12)

    Article  CAS  PubMed  Google Scholar 

  22. Westenfeld R, Schäfer C, Krüger T, Haarmann C, Schurgers LJ, Reutelingsperger C, Ivanovski O, Drueke T, Massy ZA, Ketteler M, Floege J, Jahnen-Dechent W (2009) Fetuin-A protects against atherosclerotic calcification in CKD. J Am Soc Nephrol 20(6):1264–1274

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Rivet J, Lebbé C, Urena P, Cordoliani F, Martinez F, Baglin AC, Aubert P, Aractingi S, Ronco P, Fournier P, Janin A (2006) Cutaneous calcification in patients with end-stage renal disease: a regulated process associated with in situ osteopontin expression. Arch Dermatol 142(7):900–906

    Article  PubMed  Google Scholar 

  24. Rosenberg M, Zugck C, Nelles M, Juenger C, Frank D, Remppis A, Giannitsis E, Katus HA, Frey N (2008) Osteopontin, a new prognostic biomarker in patients with chronic heart failure. Circ Heart Fail 1(1):43–49

    Article  CAS  PubMed  Google Scholar 

  25. Wang KX, Denhardt DT (2008) Osteopontin: role in immune regulation and stress responses. Cytokine Growth Factor Rev 19(5–6):333–345

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to O. Ulutas.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study was conducted on human participants. The study was approved by the Ethical Committee of Inonu University, Malatya, Turkey, and is supported by scientific research and the project’s unit of Inonu University. File No. 2012/148.

Informed consent

Informed consent was obtained from all participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ulutas, O., Taskapan, M.C., Dogan, A. et al. Vascular calcification is not related to serum fetuin-A and osteopontin levels in hemodialysis patients. Int Urol Nephrol 50, 137–142 (2018). https://doi.org/10.1007/s11255-017-1740-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-017-1740-6

Keywords

Navigation