Osteocalcin and vascular calcification in hemodialysis patients: an observational cohort study



Vascular calcification contributes to morbidity and mortality in patients with ESRD on maintenance hemodialysis.


To study the relationship between osteocalcin and vascular calcification.


160 patients with ESRD on maintenance hemodialysis and 60 age-and sex-matched healthy controls were recruited. Serum vitamin K2 and osteocalcin both intact and undercarboxylated were measured. Transthoracic echocardiography was done for valvular calcification and thickening, and carotid duplex was done for carotid intimal medial calcification and thickening.


Hemodialysis patients have higher median serum vitamin K2 (p < 0.001), higher undercarboxylated osteocalcin (p < 0.001). Only older age, duration of hypertension, and duration of established cardiovascular disease are associated with carotid media-intimal calcification. Old age is a strong predictor of carotid media intimal thickening. Female sex is associated with a valvular thickening.


Functional vitamin K deficiency is present in maintenance hemodialysis patients and serum osteocalcin is not associated with cardiovascular calcification.

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Fig. 1


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We thank our colleagues from the Internal Medicine department who provided insight and expertise that greatly assisted the research.

Author information




AMSS and HKHK equally contributed to the conception and design of the research; NIO contributed to the design of the research; MAYB contributed to the acquisition and analysis of the data; AMSS and NIO contributed to the interpretation of data; and HKHK and MAYB drafted the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

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Correspondence to Hesham Kamal Habeeb Keryakos.

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The authors declare that they have no conflicts of interest.

Statement of Ethics

The research was conducted in accordance with the ethical standards of the Minia University committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.

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Keryakos, H.K.H., Okaily, N.I., Boulis, M.A.Y. et al. Osteocalcin and vascular calcification in hemodialysis patients: an observational cohort study. Int Urol Nephrol (2021). https://doi.org/10.1007/s11255-020-02753-y

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  • Cardiovascular calcification
  • Hemodialysis
  • Osteocalcin
  • Vitamin K2
  • Valvular thickening