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Osteoprotegerin and mortality in hemodialysis patients with cardiovascular disease
Insights
High levels of Osteoprotegerin (OPG) indicate a higher risk of death in hemodialysis patients with cardiovascular disease (CVD). This study confirms OPG as a significant prognostic marker for mortality in this high-risk group.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- Patients undergoing hemodialysis (HD) face elevated mortality rates, primarily due to cardiovascular disease (CVD).
- Osteoprotegerin (OPG) plays a role in vascular calcification and has been suggested as a mortality predictor.
- Previous research indicates OPG's potential as a prognostic marker for mortality.
Purpose of the Study:
- To determine if Osteoprotegerin (OPG) serves as a prognostic marker for all-cause mortality.
- To investigate OPG's role in high-risk patients with end-stage renal disease (ESRD) and existing CVD.
Main Methods:
- A prospective study followed 206 hemodialysis patients with established cardiovascular disease.
- Osteoprotegerin (OPG) levels were measured at baseline.
- Patients were monitored for 2 years or until death, with all-cause mortality as the primary endpoint.
Main Results:
- The 2-year all-cause mortality rate was 44% (90/206).
- Elevated OPG levels were associated with increased mortality risk.
- Multivariate analysis identified age, CRP, and high OPG levels as independent predictors of mortality (p-trend=0.03).
Conclusions:
- High Osteoprotegerin (OPG) levels are an independent risk marker for all-cause mortality.
- This finding is significant in the high-risk population of hemodialysis patients with cardiovascular disease.
- OPG may aid in risk stratification for hemodialysis patients with CVD.
Background:
Patients treated with hemodialysis (HD) have an increased mortality, mainly caused by cardiovascular disease (CVD). Osteoprotegerin (OPG) is a glycoprotein involved in the regulation of the vascular calcification process. Previous studies have demonstrated that OPG is a prognostic marker of mortality. The aim of this study was to investigate if OPG was a prognostic marker of all-cause mortality in high-risk patients with end-stage renal disease and CVD.
Methods:
We prospectively followed 206 HD patients with CVD. OPG was measured at baseline and the patients were followed for 2 years or until reaching the primary endpoint, i.e., all-cause mortality.
Results:
All-cause mortality during follow-up was 44% (90/206). High OPG was associated with increased mortality, using the first tertile as reference, with an unadjusted HR of 1.70 (CI 1.00 - 2.88) for the second tertile and HR of 1.63 (CI 0.96 - 2.78) for the third tertile. In a multivariate Cox-regression analysis age, CRP and OPG in both the second and third tertile were significantly associated with increased mortality In the unadjusted survival analysis, a test for trend of OPG yielded a p-value of 0.08; in the adjusted analyses, the p-value for trend was 0.03.
Conclusions:
In a high-risk population of hemodialysis patients with previously documented cardiovascular disease, a high level of OPG was an independent risk marker of all-cause mortality.
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