The Relationship of Fetuin-A with Coronary Calcification, Carotid Atherosclerosis, and Mortality Risk in Non-Dialysis...

Area of Science:

• Nephrology
• Cardiology
• Biochemistry

Background:

• Chronic kidney disease (CKD) is associated with increased cardiovascular risk.
• Biomarkers predicting cardiovascular complications in non-dialysis CKD patients are crucial for risk stratification.

Purpose of the Study:

• To investigate the association of fetuin-A with coronary artery calcification (CAC), carotid atherosclerosis, and mortality in non-dialysis CKD patients.
• To determine if fetuin-A predicts cardiovascular events and mortality in this population.

Main Methods:

• Study included 135 adult patients with CKD stages 3-5, excluding smokers, diabetics, and those with inflammatory conditions, liver disease, acute kidney failure, hemodialysis, or cancer.
• Evaluated serum levels of fetuin-A, inflammatory markers (TNF-α, hs-CRP, IL-6), lipids, PTH, and phosphorus.
• Assessed coronary artery calcification (CAC) using cardiac spiral CT (Agatston method) and carotid atherosclerosis (IMT, plaques) via ultrasonography.

Main Results:

• Patients with CAC exhibited significantly higher levels of inflammatory markers, lipids, PTH, and phosphorus, and lower levels of fetuin-A compared to non-CAC patients (p<0.001).
• Fetuin-A levels decreased with CKD progression.
• Fetuin-A, age, inflammatory markers, lipids, PTH, and phosphorus were significant predictors of CAC. Both CAC and fetuin-A strongly predicted all-cause and cardiovascular mortality. Fetuin-A also predicted carotid intima-media thickness (CIMT).

Conclusions:

• Fetuin-A is a reliable predictor of coronary artery calcification and carotid atherosclerosis in non-dialysis CKD.
• Fetuin-A and CAC are significant risk factors for all-cause and cardiovascular mortality in patients with non-dialysis CKD.