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Calcification Propensity of Serum is Independent of Excretory Renal Function

Bernhard Bielesz1, Thomas Reiter2, Rodrig Marculescu3

  • 1Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria. bernhard.bielesz@meduniwien.ac.at.

Scientific Reports
|December 22, 2017
PubMed

Insights

Vascular calcification propensity (T50) in chronic kidney disease (CKD) patients is linked to mineral metabolism, not kidney function. Serum phosphate and calcium levels significantly influence T50, indicating calcification risk is tied to these factors.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Vascular calcification is a key factor in cardiovascular disease mortality among chronic kidney disease (CKD) patients.
  • The T50-test measures serum calcification propensity, which correlates with adverse outcomes in CKD.
  • Calcification propensity generally increases with CKD severity.

Purpose of the Study:

  • To determine if T50 is directly dependent on estimated glomerular filtration rate (eGFR) or influenced by bone and mineral metabolism derangements in CKD.
  • To investigate the relationship between T50 and various markers of calcification and mineral metabolism in CKD patients.

Main Methods:

  • A cross-sectional study involving 118 CKD patients (stages 1-5).
  • Measurement of T50, eGFR, and serum markers including phosphate, calcium, magnesium, fetuin A, albumin, bicarbonate, Parathyroid Hormone (PTH), Fibroblast Growth Factor 23 (FGF-23), and serum cross-laps.
  • Statistical analysis including correlations and partial correlations to assess associations between T50 and measured parameters.

Main Results:

  • T50 showed a correlation with eGFR, but this association was largely explained by serum phosphate and calcium levels.
  • Phosphate, magnesium, fetuin A, albumin, bicarbonate, and serum cross-laps were significantly associated with T50 in multivariate models.
  • Parathyroid Hormone and Fibroblast Growth Factor 23 were not significantly associated with T50.

Conclusions:

  • T50 values in CKD patients are primarily determined by the serum concentrations of calcification promoters and inhibitors.
  • Excretory kidney function (eGFR) is not the main driver of T50, underscoring the role of mineral metabolism in vascular calcification risk.

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