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Elevated osteoprotegerin is associated with all-cause mortality in CKD stage 4 and 5 patients in addition to vascular

Mhairi K Sigrist1, Adeera Levin, Lee Er

  • 1School of Graduate Entry Medicine and Health, The University of Nottingham, Derby, UK. msigrist@providencehealth.bc.ca

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|June 4, 2009
PubMed

Insights

Osteoprotegerin (OPG) and vascular calcification predict death in chronic kidney disease (CKD) patients. This study highlights OPG as an independent predictor of mortality, beyond its association with vascular damage.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Biology

Background:

  • Cardiovascular disease is the primary cause of mortality in chronic kidney disease (CKD) patients.
  • Mechanisms underlying vascular damage in CKD are not fully elucidated.
  • Vascular calcification (VC) is a known contributor to adverse outcomes in CKD.

Purpose of the Study:

  • To prospectively investigate novel mediators of vascular damage in CKD.
  • To assess the combined impact of vascular calcification and novel mediators on patient survival.
  • To identify predictors of mortality in patients with chronic kidney disease.

Main Methods:

  • 134 CKD patients (60 hemodialysis, 28 peritoneal dialysis, 46 stage 4) were followed for 40 months.
  • Vascular calcification (VC) assessed via CT scan; circulating osteoprotegerin (OPG), Fetuin-A, and hs-CRP measured.
  • Standard clinical and biochemical analyses performed.

Main Results:

  • 31 deaths occurred over 40 months, with all deceased patients exhibiting significant VC.
  • Male gender, elevated OPG levels (>25 pmol/L), and hypoalbuminemia were associated with increased mortality risk.
  • Osteoprotegerin (OPG) emerged as an independent predictor of mortality, irrespective of C-reactive protein (CRP) levels.

Conclusions:

  • Vascular calcification (VC) and low albumin predict death in advanced CKD stages.
  • Osteoprotegerin (OPG) is independently associated with a negative prognosis in CKD patients.
  • Further research is needed to elucidate the mechanisms linking OPG to vascular damage and mortality in CKD.
Abstract

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