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Published on: October 2, 2020
Osteopontin and Clinical Outcomes in Hemodialysis Patients
Claudia Torino1, Federico Carbone2,3, Patrizia Pizzini1
1Clinical Epidemiology of Renal Disease and Hypertension Unit, Reggio Cal CNR Unit of the Pisa CNR Institute of Clinical Physiology, 89124 Reggio Calabria, Italy.
Insights
Elevated osteopontin levels predict higher mortality risk in hemodialysis patients. This glycoprotein is linked to increased cardiovascular events and death, suggesting its role in kidney disease complications.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Biomarker Research
Background:
- Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) pose significant public health challenges.
- Cardiovascular disease is the primary cause of mortality in hemodialysis patients.
- Osteopontin (OPN), a glycoprotein involved in inflammation and calcification, is a potential vascular disease biomarker in CKD.
Purpose of the Study:
- To investigate the association between serum osteopontin levels and mortality in hemodialysis patients.
- To determine if osteopontin is an independent predictor of all-cause and cardiovascular mortality.
Main Methods:
- A cohort study of 1124 hemodialysis patients from the PROGREDIRE study.
- Serum osteopontin levels measured by ELISA.
- Multivariate Cox regression analyses adjusted for confounders.
Main Results:
- Elevated osteopontin levels were significantly associated with increased all-cause mortality (HR 1.19).
- Elevated osteopontin levels were significantly associated with increased cardiovascular mortality (HR 1.22).
- Osteopontin levels correlated with alkaline phosphatase and parathyroid hormone.
Conclusions:
- Increased osteopontin levels are linked to higher mortality in hemodialysis patients.
- Osteopontin may play a role in the elevated cardiovascular risk observed in this population.
- Further intervention studies are warranted to confirm these findings.
Background/Objectives:
Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are significant public health issues, with cardiovascular morbidity and mortality being the leading causes of death in hemodialysis patients. Osteopontin (OPN), a multifunctional glycoprotein, has emerged as a potential biomarker for vascular disease in CKD due to its role in inflammation, tissue remodeling, and calcification.
Methods:
This cohort study included 1124 hemodialysis patients from the PROGREDIRE study, a registry involving 35 dialysis units in Southern Italy. Serum osteopontin levels were measured using enzyme-linked immunosorbent assay (ELISA). The primary endpoints were all-cause and cardiovascular mortality. Multivariate Cox regression analyses were performed to assess the association between osteopontin levels and mortality, adjusting for traditional risk factors, biomarkers of inflammation, nutritional status, and ESKD-related factors.
Results:
During a mean follow-up of 2.8 years, 478 patients died, 271 from cardiovascular causes. Independent correlates of osteopontin included alkaline phosphatase and parathyroid hormone. Elevated osteopontin levels were significantly associated with increased all-cause mortality (HR 1.19, 95% CI 1.09-1.31, p < 0.001) and cardiovascular mortality (HR 1.22, 95% CI 1.08-1.38, p = 0.001) after adjusting for confounders.
Conclusions:
Elevated osteopontin levels are associated with increased all-cause and cardiovascular mortality in hemodialysis patients. These findings implicate osteopontin in the high risk for death and cardiovascular disease in the hemodialysis population. Intervention studies are needed to definitively test this hypothesis.
