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Arterial calcifications and osteoprotegerin in chronic hemodialysis patients: impact on 6-year survival

  • Nephrology - Original Paper
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Abstract

Aim

The association between end-stage renal disease and cardiovascular mortality may be influenced through vascular alterations, in particular atherosclerosis and vascular calcification. The study goal was to assess the impact of each type of arterial intimal calcifications (AIC) and arterial medial calcifications (AMC), of osteoprotegerin (OPG), mineral metabolism markers and other features on all-cause and cardiovascular mortality in chronic hemodialysis patients.

Methods

Ultrasound was performed in 87 patients on the carotid and femoral arteries, and the severity of AIC and AMC was assessed calculating a score according to the extension of calcification. We analyzed the link between AIC, AMC, OPG, mineral markers and mortality after 6 years of follow-up.

Results

The cutoff value for OPG determined using ROC was 4.9 pmol/l for all-cause and cardiovascular mortality. Patients with higher serum OPG levels presented higher mortality rates. Our study revealed that AIC, high OPG, low ankle-arm index, presence of diabetes, smoking status, and lack of arteriovenous fistula are associated with all-cause and cardiovascular mortality in univariate regression analysis. Multivariate analysis identified AIC scoring based on the segmentation method as an independent predictor of all-cause and cardiovascular mortality, along with increased OPG levels. AMC scoring was not a predictor of mortality.

Conclusions

Identifying and scoring AIC on ultrasound and measuring OPG levels, as a basis of the HD patient assessment may become valuable tools in clinical work, as these have an impact on death toll.

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Acknowledgements

We would like to thank the patients and personnel involved in the creation of this cohort; their collaboration made the study possible.

Funding

There is no specific funding for this research involved in collection, analysis, interpretation of data and in writing of the manuscript.

Author information

Authors and Affiliations

  1. Department of Nephrology, University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania

    Diana Moldovan, Crina Rusu, Alina Potra, Maria Ticala, Dacian Tirinescu, Anca Coman & Ina Kacso

  2. Department of Statistics, University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania

    Cosmina Bondor

  3. 4th Medical Department, University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania

    Olga Orasan

  4. Emergency Military Hospital, Cluj-Napoca, Romania

    Ioan Moldovan

  5. Nefromed Dialysis Center, Cluj-Napoca, Romania

    Remus Orasan

Authors
  1. Diana Moldovan
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  2. Crina Rusu
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  3. Alina Potra
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  4. Cosmina Bondor
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  9. Ioan Moldovan
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  11. Ina Kacso
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Corresponding author

Correspondence to Diana Moldovan.

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Conflict of interest

The authors declare no competing interests.

Ethical standards

This study was approved by the Ethics Committee for Scientific Research of the University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania; the study respected the ethical standards of the Declaration of Helsinki.

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All included patients agreed to participate in the study and signed the informed consent.

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Moldovan, D., Rusu, C., Potra, A. et al. Arterial calcifications and osteoprotegerin in chronic hemodialysis patients: impact on 6-year survival. Int Urol Nephrol 54, 1135–1143 (2022). https://doi.org/10.1007/s11255-021-02988-3

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  • DOI: https://doi.org/10.1007/s11255-021-02988-3

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