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Published on: April 12, 2021
Sclerostin is an independent risk factor for all-cause mortality in kidney transplant recipients
Shufei Zeng1,2, Torsten Slowinski1, Wolfgang Pommer3
1Department of Nephrology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
Insights
Elevated sclerostin levels predict mortality in kidney transplant recipients. Higher baseline plasma sclerostin is an independent risk factor for all-cause mortality post-transplantation.
Area of Science:
- Nephrology
- Endocrinology
- Cardiovascular Medicine
Background:
- Sclerostin influences bone-vascular interactions.
- Sclerostin is linked to cardiovascular events and mortality in chronic kidney disease (CKD).
Purpose of the Study:
- To investigate the association between sclerostin levels and mortality in renal transplant recipients.
Main Methods:
- A 3-year follow-up study of 600 stable renal transplant recipients.
- Kaplan-Meier survival analysis and Cox regression models were used.
- Confounding factors including age, eGFR, and albumin were considered.
Main Results:
- Nonsurvivors exhibited significantly higher plasma sclerostin levels than survivors (p=0.0036).
- Baseline sclerostin concentrations were associated with all-cause mortality (p=0.0085).
- Plasma sclerostin remained an independent predictor of all-cause mortality (HR 1.011, p=0.0137).
Conclusions:
- Baseline plasma sclerostin is an independent risk factor for all-cause mortality in kidney transplant recipients.
Background:
Sclerostin is a hormone contributing to the bone-vascular wall cross talk and has been implicated in cardiovascular events and mortality in patients with chronic kidney disease (CKD). We analyzed the relationship between sclerostin and mortality in renal transplant recipients.
Methods:
600 stable renal transplant recipients (367men, 233 women) were followed for all-cause mortality for 3 years. Blood and urine samples for analysis and clinical data were collected at study entry. We performed Kaplan-Meier survival analysis and Cox regression models considering confounding factors such as age, eGFR, cold ischemia time, HbA1c, phosphate, calcium, and albumin. Optimal cut-off values for the Cox regression model were calculated based on ROC analysis.
Results:
Sixty-five patients died during the observation period. Nonsurvivors (n = 65; sclerostin 57.31 ± 30.28 pmol/L) had higher plasma sclerostin levels than survivors (n = 535; sclerostin 47.52 ± 24.87 pmol/L) (p = 0.0036). Kaplan-Meier curve showed that baseline plasma sclerostin concentrations were associated with all-cause mortality in stable kidney transplant recipients (p = 0.0085, log-rank test). After multiple Cox regression analysis, plasma levels of sclerostin remained an independent predictor of all-cause mortality (hazard ratio, 1.011; 95% CI 1.002-1.020; p = 0.0137).
Conclusions:
Baseline plasma sclerostin is an independent risk factor for all-cause mortality in patients after kidney transplantation.
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01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:29Acute Kidney Injury II: Pathophysiology
01:24Chronic Kidney Disease II: Clinical Manifestations