Skip to main content
Top
Published in: International Urology and Nephrology 1/2018

01-01-2018 | Nephrology - Original Paper

Vascular calcification is not related to serum fetuin-A and osteopontin levels in hemodialysis patients

Authors: O. Ulutas, M. C. Taskapan, A. Dogan, T. Baysal, H. Taskapan

Published in: International Urology and Nephrology | Issue 1/2018

Login to get access

Abstract

Introduction

Vascular calcification (VC) in hemodialysis (HD) patients is a sign of severe cardiovascular disease and can predict cardiovascular outcomes. Fetuin-A and osteopontin (OPN) inhibit VC. Serum fetuin-A levels are lower in patients with end-stage kidney disease (ESKD) and in those who are on chronic HD therapy. However, there are limited data concerning OPN in patients who are on dialysis. The aim of our study was to determine VC in HD patients, the relationship between VC and 25-OH-vitamin D, fetuin-A, and OPN levels, and independent predictors of VC.

Materials and methods

Ninety-three patients with ESKD on HD therapy were recruited. Among these patients, 44 were male and 49 were female. The patient group was compared with a group of 20 healthy controls of similar age and sex. A plain radiograph of the hand was taken using a mammography machine for the evaluation of VC. Serum fetuin-A, OPN, and 25-OH-vitamin D levels of both patients and controls were measured.

Results

VC was detected in 45 (48.4%) HD patients. When patients were compared with healthy controls, fetuin-A levels (p < 0.029) were significantly lower in patients, whereas OPN (p < 0.000) and VC (p < 0.002) were significantly higher in the patient group. Age [odds ratio (OR) 1.036], the presence of diabetes mellitus (DM) (OR 17.527), and high parathyroid hormone (PTH) levels (OR 1.002) were independent predictors of VC in a logistic regression model including the following factors: age, the presence of DM, HD duration, and serum albumin, phosphate, PTH, 25-OH-vitamin D, fetuin-A, OPN, and calcium levels. No significant correlation was found between patients with VC and patients without VC in terms of fetuin-A, OPN, and 25-OH-vitamin D levels.

Conclusions

VC is a frequent sign in patients undergoing HD and is not related to serum fetuin-A and osteopontin levels. Age, the presence of DM, and high PTH levels were independent predictors of VC in patients undergoing HD. Further studies are warranted to understand the mechanism underlying and the factors contributing to VC.
Literature
1.
go back to reference National Kidney foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266 National Kidney foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266
2.
go back to reference Collins AJ, Kasiske B, Herzog C, Chen SC, Everson S, Constantini E, Grimm R, McBean M, Xue J, Chavers B, Matas A, Manning W, Louis T, Pan W, Liu J, Li S, Roberts T, Dalleska F, Snyder J, Ebben J, Frazier E, Sheets D, Johnson R, Li S, Dunning S, Berrini D, Guo H, Solid C, Arko C, Daniels F, Wang X, Forrest B, Gilbertson D, St Peter W, Frederick P, Eggers P, Agodoa L (2003) Excerpts from the United States Renal Data System 2003 annual data report: atlas of end-stage renal disease in the United States. Am J Kidney Dis 42(6 Suppl 5):A5–A7, S1–S230PubMed Collins AJ, Kasiske B, Herzog C, Chen SC, Everson S, Constantini E, Grimm R, McBean M, Xue J, Chavers B, Matas A, Manning W, Louis T, Pan W, Liu J, Li S, Roberts T, Dalleska F, Snyder J, Ebben J, Frazier E, Sheets D, Johnson R, Li S, Dunning S, Berrini D, Guo H, Solid C, Arko C, Daniels F, Wang X, Forrest B, Gilbertson D, St Peter W, Frederick P, Eggers P, Agodoa L (2003) Excerpts from the United States Renal Data System 2003 annual data report: atlas of end-stage renal disease in the United States. Am J Kidney Dis 42(6 Suppl 5):A5–A7, S1–S230PubMed
4.
go back to reference Bostrom K, Watson KE, Horn S, Wortham C, Herman IM, Demer LL (1993) Bone morphogenetic protein expression in human atherosclerotic lesions. J Clin Invest 91:1800–1809CrossRefPubMedPubMedCentral Bostrom K, Watson KE, Horn S, Wortham C, Herman IM, Demer LL (1993) Bone morphogenetic protein expression in human atherosclerotic lesions. J Clin Invest 91:1800–1809CrossRefPubMedPubMedCentral
5.
go back to reference Shlipak MG, Heidenreich PA, Noguchi H et al (2002) Association of renal insufficiency with treatment and outcomes after myocardial infarction in elderly patients. Ann Intern Med 137:555–562CrossRefPubMed Shlipak MG, Heidenreich PA, Noguchi H et al (2002) Association of renal insufficiency with treatment and outcomes after myocardial infarction in elderly patients. Ann Intern Med 137:555–562CrossRefPubMed
6.
go back to reference Wright RS, Reeder GS, Herzog CA et al (2002) Acute myocardial infarction and renal dysfunction: a high-risk combination. Ann Intern Med 137:563–570CrossRefPubMed Wright RS, Reeder GS, Herzog CA et al (2002) Acute myocardial infarction and renal dysfunction: a high-risk combination. Ann Intern Med 137:563–570CrossRefPubMed
7.
go back to reference Keough-Ryan T, Hutchinson T, MacGibbon B, Senecal M (2002) Studies of prognostic factors in end-stage renal disease: an epidemiological statistical critique. Am J Kidney Dis 39:1196–1205CrossRefPubMed Keough-Ryan T, Hutchinson T, MacGibbon B, Senecal M (2002) Studies of prognostic factors in end-stage renal disease: an epidemiological statistical critique. Am J Kidney Dis 39:1196–1205CrossRefPubMed
8.
go back to reference London GM, Guérin AP, Marchais SJ, Métivier F, Pannier B, Adda H (2003) Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 18(9):1731–1740CrossRefPubMed London GM, Guérin AP, Marchais SJ, Métivier F, Pannier B, Adda H (2003) Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 18(9):1731–1740CrossRefPubMed
9.
go back to reference Moe SM, Reslerova M, Ketteler M, O’Neill K, Duan D, Koczman J, Westenfeld R, Jahnen-Dechent W, Chen NX (2005) Role of calcification inhibitors in the pathogenesis of vascular calcification in chronic kidney disease (CKD). Kidney Int 67:2295–2304CrossRefPubMed Moe SM, Reslerova M, Ketteler M, O’Neill K, Duan D, Koczman J, Westenfeld R, Jahnen-Dechent W, Chen NX (2005) Role of calcification inhibitors in the pathogenesis of vascular calcification in chronic kidney disease (CKD). Kidney Int 67:2295–2304CrossRefPubMed
10.
go back to reference Cozzolino M, Galassi A, Biondi ML, Turri O, Papagni S, Mongelli N, Civita L, Gallieni M, Brancaccio D (2006) Serum fetuin-A levels link inflammation and cardiovascular calcification in hemodialysis patients. Am J Nephrol 26:423–429CrossRefPubMed Cozzolino M, Galassi A, Biondi ML, Turri O, Papagni S, Mongelli N, Civita L, Gallieni M, Brancaccio D (2006) Serum fetuin-A levels link inflammation and cardiovascular calcification in hemodialysis patients. Am J Nephrol 26:423–429CrossRefPubMed
11.
go back to reference Russo D, Corrao S, Miranda I, Ruocco C, Manzi S, Elefante R, Brancaccio D, Cozzolino M, Biondi ML, Andreucci VE (2007) Progression of coronary artery calcification in predialysis patients. Am J Nephrol 27:152–158CrossRefPubMed Russo D, Corrao S, Miranda I, Ruocco C, Manzi S, Elefante R, Brancaccio D, Cozzolino M, Biondi ML, Andreucci VE (2007) Progression of coronary artery calcification in predialysis patients. Am J Nephrol 27:152–158CrossRefPubMed
12.
go back to reference Zheng S, de Las Fuentes L, Bierhals A, Ash-Bernal R, Spence K, Slatopolsky E, Davila-Roman VG, Delmez J (2009) Relation of serum fetuin-A levels to coronary artery calcium in African–American patients on chronic hemodialysis. Am J Cardiol 103:46–49CrossRefPubMed Zheng S, de Las Fuentes L, Bierhals A, Ash-Bernal R, Spence K, Slatopolsky E, Davila-Roman VG, Delmez J (2009) Relation of serum fetuin-A levels to coronary artery calcium in African–American patients on chronic hemodialysis. Am J Cardiol 103:46–49CrossRefPubMed
13.
go back to reference Mikami S, Hamano T, Fujii N, Nagasawa Y, Isaka Y, Moriyama T, Matsuhisa M, Ito T, Imai E, Hori M (2008) Serum osteoprotegerin as a screening tool for coronary artery calcification score in diabetic pre-dialysis patients. Hypertens Res 31:1163–1170CrossRefPubMed Mikami S, Hamano T, Fujii N, Nagasawa Y, Isaka Y, Moriyama T, Matsuhisa M, Ito T, Imai E, Hori M (2008) Serum osteoprotegerin as a screening tool for coronary artery calcification score in diabetic pre-dialysis patients. Hypertens Res 31:1163–1170CrossRefPubMed
14.
go back to reference Jung HH, Kim SW, Han H (2006) Inflammation, mineral metabolism and progressive coronary artery calcification in patients on haemodialysis. Nephrol Dial Transplant 21:1915–1920CrossRefPubMed Jung HH, Kim SW, Han H (2006) Inflammation, mineral metabolism and progressive coronary artery calcification in patients on haemodialysis. Nephrol Dial Transplant 21:1915–1920CrossRefPubMed
15.
go back to reference Herrmann SM, Whatling C, Brand E, Nicaud V, Gariepy J, Simon A, Evans A, Ruidavets JB, Arveiler D, Luc G, Tiret L, Henney A, Cambien F (2000) Polymorphisms of the human matrix gla protein (MGP) gene, vascular calcification, and myocardial infarction. Arterioscler Thromb Vasc Biol 20:2386–2393CrossRefPubMed Herrmann SM, Whatling C, Brand E, Nicaud V, Gariepy J, Simon A, Evans A, Ruidavets JB, Arveiler D, Luc G, Tiret L, Henney A, Cambien F (2000) Polymorphisms of the human matrix gla protein (MGP) gene, vascular calcification, and myocardial infarction. Arterioscler Thromb Vasc Biol 20:2386–2393CrossRefPubMed
16.
go back to reference Miyauchi A, Alvarez J, Greenfield EM, Teti A, Grano M, Colucci S, Zambonin-Zallone A, Ross FP, Teitelbaum SL, Cheresh D et al (1991) Recognition of osteopontin and related peptides by an alpha v beta 3 integrin stimulates immediate cell signals in osteoclasts. J Biol Chem 266:20369–20374PubMed Miyauchi A, Alvarez J, Greenfield EM, Teti A, Grano M, Colucci S, Zambonin-Zallone A, Ross FP, Teitelbaum SL, Cheresh D et al (1991) Recognition of osteopontin and related peptides by an alpha v beta 3 integrin stimulates immediate cell signals in osteoclasts. J Biol Chem 266:20369–20374PubMed
17.
go back to reference Steitz SA, Speer MY, McKee MD, Liaw L, Almeida M, Yang H, Giachelli CM (2002) Osteopontin inhibits mineral deposition and promotes regression of ectopic calcification. Am J Pathol 161:2035–2046CrossRefPubMedPubMedCentral Steitz SA, Speer MY, McKee MD, Liaw L, Almeida M, Yang H, Giachelli CM (2002) Osteopontin inhibits mineral deposition and promotes regression of ectopic calcification. Am J Pathol 161:2035–2046CrossRefPubMedPubMedCentral
18.
go back to reference Wada T, McKee MD, Steitz S, Giachelli CM (1999) Calcification of vascular smooth muscle cell cultures: inhibition by osteopontin. Circ Res 84:166–178CrossRefPubMed Wada T, McKee MD, Steitz S, Giachelli CM (1999) Calcification of vascular smooth muscle cell cultures: inhibition by osteopontin. Circ Res 84:166–178CrossRefPubMed
19.
go back to reference Lee CT, Chua S, Hsu CY, Tsai YC, Ng HY, Kuo CC, Wu CH, Chen TC, Chiu TT, Lee YT (2013) Biomarkers associated with vascular and valvular calcification in chronic hemodialysis patients. Dis Markers 34(4):229–235CrossRefPubMedPubMedCentral Lee CT, Chua S, Hsu CY, Tsai YC, Ng HY, Kuo CC, Wu CH, Chen TC, Chiu TT, Lee YT (2013) Biomarkers associated with vascular and valvular calcification in chronic hemodialysis patients. Dis Markers 34(4):229–235CrossRefPubMedPubMedCentral
21.
go back to reference Barreto DV, Lenglet A, Liabeuf S, Kretschmer A, Barreto FC, Nollet A, Slama M, Choukroun G, Brazier M, Massy Z (2011) Prognostic implication of plasma osteopontin levels in patients with chronic kidney disease. Nephron Clin Pract 117(4):c363–c372. https://doi.org/10.1159/000321520 (Epub 2010 Nov 12) CrossRefPubMed Barreto DV, Lenglet A, Liabeuf S, Kretschmer A, Barreto FC, Nollet A, Slama M, Choukroun G, Brazier M, Massy Z (2011) Prognostic implication of plasma osteopontin levels in patients with chronic kidney disease. Nephron Clin Pract 117(4):c363–c372. https://​doi.​org/​10.​1159/​000321520 (Epub 2010 Nov 12) CrossRefPubMed
22.
go back to reference Westenfeld R, Schäfer C, Krüger T, Haarmann C, Schurgers LJ, Reutelingsperger C, Ivanovski O, Drueke T, Massy ZA, Ketteler M, Floege J, Jahnen-Dechent W (2009) Fetuin-A protects against atherosclerotic calcification in CKD. J Am Soc Nephrol 20(6):1264–1274CrossRefPubMedPubMedCentral Westenfeld R, Schäfer C, Krüger T, Haarmann C, Schurgers LJ, Reutelingsperger C, Ivanovski O, Drueke T, Massy ZA, Ketteler M, Floege J, Jahnen-Dechent W (2009) Fetuin-A protects against atherosclerotic calcification in CKD. J Am Soc Nephrol 20(6):1264–1274CrossRefPubMedPubMedCentral
23.
go back to reference Rivet J, Lebbé C, Urena P, Cordoliani F, Martinez F, Baglin AC, Aubert P, Aractingi S, Ronco P, Fournier P, Janin A (2006) Cutaneous calcification in patients with end-stage renal disease: a regulated process associated with in situ osteopontin expression. Arch Dermatol 142(7):900–906CrossRefPubMed Rivet J, Lebbé C, Urena P, Cordoliani F, Martinez F, Baglin AC, Aubert P, Aractingi S, Ronco P, Fournier P, Janin A (2006) Cutaneous calcification in patients with end-stage renal disease: a regulated process associated with in situ osteopontin expression. Arch Dermatol 142(7):900–906CrossRefPubMed
24.
go back to reference Rosenberg M, Zugck C, Nelles M, Juenger C, Frank D, Remppis A, Giannitsis E, Katus HA, Frey N (2008) Osteopontin, a new prognostic biomarker in patients with chronic heart failure. Circ Heart Fail 1(1):43–49CrossRefPubMed Rosenberg M, Zugck C, Nelles M, Juenger C, Frank D, Remppis A, Giannitsis E, Katus HA, Frey N (2008) Osteopontin, a new prognostic biomarker in patients with chronic heart failure. Circ Heart Fail 1(1):43–49CrossRefPubMed
25.
go back to reference Wang KX, Denhardt DT (2008) Osteopontin: role in immune regulation and stress responses. Cytokine Growth Factor Rev 19(5–6):333–345CrossRefPubMed Wang KX, Denhardt DT (2008) Osteopontin: role in immune regulation and stress responses. Cytokine Growth Factor Rev 19(5–6):333–345CrossRefPubMed
Metadata
Title
Vascular calcification is not related to serum fetuin-A and osteopontin levels in hemodialysis patients
Authors
O. Ulutas
M. C. Taskapan
A. Dogan
T. Baysal
H. Taskapan
Publication date
01-01-2018
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 1/2018
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-017-1740-6

Other articles of this Issue 1/2018

International Urology and Nephrology 1/2018 Go to the issue