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Updated: May 5, 2026
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Relationship between aortic pulse wave velocity, selected proinflammatory cytokines, and vascular calcification
Marcin Krzanowski1, Katarzyna Janda, Paulina Dumnicka
1aDepartment of Nephrology bDepartment of Medical Diagnostics cDepartment of Internal Medicine and Gerontology dDepartment of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Cracow, Poland.
Insights
In chronic kidney disease (CKD) patients on peritoneal dialysis, osteocalcin levels are the strongest predictor of arterial stiffness, as measured by aortic pulse wave velocity (AoPWV). Inflammatory markers and osteoprotegerin (OPG) also influence arterial stiffness in this population.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Vascular calcification and arterial stiffening are significant cardiovascular risk factors in chronic kidney disease (CKD) patients.
- Elevated aortic pulse wave velocity (AoPWV) independently predicts increased cardiovascular morbidity and mortality in CKD.
- Peritoneal dialysis (PD) is a common treatment modality for CKD patients, often associated with cardiovascular complications.
Purpose of the Study:
- To investigate the associations between inflammatory markers, vascular calcification parameters, and arterial wall stiffness in CKD patients undergoing peritoneal dialysis.
- To identify key predictors of arterial stiffness, specifically AoPWV, in this patient cohort.
Main Methods:
- A cohort of 57 CKD patients on peritoneal dialysis was studied.
- Measurements included serum levels of inflammatory markers (IL-6, TGF-β1, WBC), vascular calcification markers (osteocalcin, OPG, FGF23, fetuin A), and biochemical parameters (albumin, lipids, iPTH, Ca, Pi).
- Arterial stiffness was assessed using AoPWV (tonometry), common carotid artery intima-media thickness (CCA-IMT, ultrasonography), and calcium scoring (CaSc, MSCT).
Main Results:
- AoPWV showed significant positive correlations with OPG, IL-6, TGF-β1, WBC count, CCA-IMT, and CaSc.
- AoPWV correlated negatively with osteocalcin.
- After multivariate adjustments, osteocalcin emerged as the sole significant predictor of AoPWV, with lower osteocalcin associated with higher arterial stiffness.
Conclusions:
- Osteoprotegerin (OPG) concentration and inflammatory markers (WBC, IL-6, TGF-β1) contribute to the severity of arterial stiffness in CKD patients on PD.
- Osteocalcin measurement appears to be the most reliable predictor of AoPWV in this population.
- These findings highlight the complex interplay of inflammation, calcification, and arterial stiffness in CKD patients and suggest osteocalcin as a potential therapeutic target.
Introduction:
Vascular calcification and arterial stiffening are cardiovascular risk factors among chronic kidney disease patients. Elevated aortic pulse wave velocity (AoPWV) is an independent predictor of increased cardiovascular morbidity and mortality.
Objectives:
The aim of the study was to analyze the relationships between inflammatory and vascular calcification parameters and arterial wall stiffness in chronic kidney disease (CKD) patients treated by peritoneal dialysis.
Patients And Methods:
The study included 57 patients (27 women and 30 men) aged from 19 to 75 years (mean age 53 ± 13), treated by peritoneal dialysis during 4-100 months (mean 30.4 months). The concentrations of albumin, lipids, interleukin-6 (IL-6), IL-18, high-sensitive C-reactive protein, transforming growth factor-β1 (TGF-β1), osteocalcin, osteoprotegerin (OPG), fibroblast growth factor 23, fetuin A, parathyroid hormone (iPTH), total calcium (Ca), and phosphates (Pi) were measured. AoPWV was performed using a tonometric method, common carotid artery intima-media thickness (CCA-IMT) by ultrasonography evaluation, and calcium scoring (CaSc) with multirow spiral computed tomography (MSCT).
Results:
In univariate analysis, AoPWV correlated negatively with osteocalcin (R = -0.37; P = 0.005) and positively with OPG (R = 0.41; P = 0.002). Additionally, AoPWV was significantly positively associated with inflammatory parameters: IL-6 (R = 0.35; P = 0.009), TGF-β1 (R = 0.27; P = 0.047), and white blood cell (WBC) count (R = 0.33; P = 0.01). There were also positive correlations between AoPWV and imaging data: CCA-IMT (R = 0.32; P = 0.02) and CaSc (R = 0.38; P = 0.004). AoPWV did not correlate with calcium, phosphate, Ca × Pi index, or iPTH concentration. After multiple adjustments, osteocalcin was the only significant predictor of AoPWV. In logistic regression adjusted for age, hypertension, and mean arterial pressure at AoPWV evaluation, only osteocalcin was significantly associated with high (above median) AoPWV values [odds ratio 0.96 (0.92-0.99) per unit increase in osteocalcin].
Conclusion:
OPG concentration and some inflammatory markers (WBC count, IL-6, TGF-β1) influenced the severity of arterial wall stiffness in CKD patients. Measurement of osteocalcin seems to be the best predictor of AoPWV.
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01:30Peripheral Artery Disease I: Introduction
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications