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Circulating Osteoprotegerin in Chronic Kidney Disease and All-Cause Mortality

Joanna Kamińska1, Marek Stopiński1, Krzysztof Mucha2,3

  • 1Department of Internal Diseases and Dialysis Unit, West Hospital of Saint John Paul II, Grodzisk Mazowiecki, Poland.

International Journal of General Medicine
|June 17, 2021
PubMed

Insights

Osteoprotegerin (OPG) levels predict mortality in chronic kidney disease (CKD) patients. Measuring OPG, potentially with coronary calcium score, can help stratify mortality risk in CKD stages 3-4 and end-stage renal disease.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Chronic kidney disease (CKD) is linked to cardiovascular disease, mineral and bone disorder, and increased mortality.
  • Bone-related factors like osteopontin (OPN), osteocalcin (OC), osteoprotegerin (OPG), and fibroblast growth factor 23 (FGF23) are implicated in CKD's cardiovascular complications.
  • These factors may hold predictive value for mortality in CKD patients.

Purpose of the Study:

  • To investigate the relationship between OPN, OC, OPG, and FGF23 with clinical characteristics in CKD patients.
  • To assess the predictive ability of these bone-related factors for mortality across different stages of CKD.

Main Methods:

  • Study groups included end-stage renal disease (ESRD) (38), CKD stages 3-4 (19), and non-CKD controls (19).
  • Serum concentrations of OPN, OC, OPG, and FGF23 were measured from a single blood draw.
  • Coronary calcium score (CS) was evaluated using cardiac computed tomography, and patients were followed for 5-year all-cause mortality.

Main Results:

  • Serum OPN, OC, and OPG levels significantly increased with CKD progression and were positively correlated.
  • OPN and OPG showed significant positive correlations with coronary calcium score.
  • Serum OPG demonstrated the strongest association with declining GFR and predicted increased mortality risk in CKD3-4 and ESRD patients (HR 5.8).

Conclusions:

  • A single measurement of osteoprotegerin is associated with 5-year all-cause mortality in patients with CKD stages 3-4 or ESRD.
  • Assessing OPG concentration, ideally combined with coronary calcium score, is suggested for stratifying mortality risk in CKD patients.
Abstract

Keywords:
calcium scorechronic kidney diseaseosteocalcinosteopontinosteoprotegerin

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