Skip Navigation


NDT Advance Access originally published online on May 7, 2008
Nephrology Dialysis Transplantation 2008 23(10):3263-3271; doi:10.1093/ndt/gfn226
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
23/10/3263    most recent
gfn226v2
gfn226v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Shroff, R. C.
Right arrow Articles by Rees, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Shroff, R. C.
Right arrow Articles by Rees, L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


The circulating calcification inhibitors, fetuin-A and osteoprotegerin, but not Matrix Gla protein, are associated with vascular stiffness and calcification in children on dialysis

Rukshana C. Shroff1,2, Vanita Shah3, Melanie P. Hiorns4, Michael Schoppet5, Lorenz C. Hofbauer6, Gerhard Hawa7, Leon J. Schurgers8, Atul Singhal9, Ian Merryweather9, Paul Brogan10, Catherine Shanahan11, John Deanfield2 and Lesley Rees1

1 Nephrourology 2 Vascular Physiology 3 Infectious Disease 4 Radiology Departments, Great Ormond Street Hospital & UCL Institute of Child Health, London, UK 5 Department of Internal Medicine and Cardiology, Philipps-University, Marburg 6 Division of Endocrinology and Metabolic Bone Disease, Technical University of Dresden, Dresden, Germany 7 Biomedica Medizinprodukte, Vienna, Austria 8 CARIM and VitaK, University of Maastricht, Maastricht, The Netherlands 9 Childhood Nutrition Research Centre 10 Department of Rheumatology, Great Ormond Street Hospital & UCL Institute of Child Health, London, UK 11 Cardiovascular Division, King's College London, UK

Rukshana C. Shroff, Research Registrar, Nephrourology Unit, Institute of Child Health, 30, Guilford Street, London WC1N 1EH, UK. Tel: +44-020-7405-9200, ext 0065; Fax: +44-020-7813-8532; E-mail: ShrofR{at}gosh.nhs.uk



  Abstract

Background. Vascular calcification occurs in the majority of patients with chronic kidney disease, but a subset of patients does not develop calcification despite exposure to a similar uraemic environment. Physiological inhibitors of calcification, fetuin-A, osteoprotegerin (OPG) and undercarboxylated-matrix Gla protein (uc-MGP) may play a role in preventing the development and progression of ectopic calcification, but there are scarce and conflicting data from clinical studies.

Methods. We measured fetuin-A, OPG and uc-MGP in 61 children on dialysis and studied their associations with clinical, biochemical and vascular measures.

Results. Fetuin-A and OPG were higher and uc-MGP lower in dialysis patients than controls. In controls, fetuin-A and OPG increased with age. Fetuin-A showed an inverse correlation with dialysis vintage (P = 0.0013), time-averaged serum phosphate (P = 0.03) and hs-CRP (P = 0.001). Aortic pulse wave velocity (PWV) and augmentation index showed a negative correlation with fetuin-A while a positive correlation was seen with PWV and OPG. Patients with calcification had lower fetuin-A and higher OPG than those without calcification. On multiple linear regression analysis Fetuin-A independently predicted aortic PWV (P = 0.004, ß = –0.45, model R2 = 48%) and fetuin-A and OPG predicted cardiac calcification (P = 0.02, ß = –0.29 and P = 0.014, ß = 0.33, respectively, model R2 = 32%).

Conclusions. This is the first study to define normal levels of the calcification inhibitors in children and show that fetuin-A and OPG are associated with increased vascular stiffness and calcification in children on dialysis. Higher levels of fetuin-A in children suggest a possible protective upregulation of fetuin-A in the early stages of exposure to the pro-calcific and pro-inflammatory uraemic environment.

Keywords: dialysis; fetuin-A; matrix Gla protein; osteoprotegerin; vascular calcification

Received for publication: 23. 1.08
Accepted in revised form: 2. 4.08


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Nephrol Dial TransplantHome page
M. Morena, A.-M. Dupuy, I. Jaussent, H. Vernhet, G. Gahide, K. Klouche, A.-S. Bargnoux, C. Delcourt, B. Canaud, and J.-P. Cristol
A cut-off value of plasma osteoprotegerin level may predict the presence of coronary artery calcifications in chronic kidney disease patients
Nephrol. Dial. Transplant., November 1, 2009; 24(11): 3389 - 3397.
[Abstract] [Full Text] [PDF]

Home page
 Ann Clin BiochemHome page
M. Wigger, J. Schaible, J. Muscheites, G. Kundt, D. Haffner, and D.-C. Fischer
Fetuin-A serum concentrations in healthy children
Ann Clin Biochem, November 1, 2009; 46(6): 511 - 513.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
M. K. Sigrist, A. Levin, L. Er, and C. W. McIntyre
Elevated osteoprotegerin is associated with all-cause mortality in CKD stage 4 and 5 patients in addition to vascular calcification
Nephrol. Dial. Transplant., October 1, 2009; 24(10): 3157 - 3162.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
B. D. Parker, J. H. Ix, E. C. M. Cranenburg, C. Vermeer, M. A. Whooley, and L. J. Schurgers
Association of kidney function and uncarboxylated matrix Gla protein: Data from the Heart and Soul Study
Nephrol. Dial. Transplant., July 1, 2009; 24(7): 2095 - 2101.
[Abstract] [Full Text] [PDF]

Home page
 CJASNHome page
R. Shantouf, C. P. Kovesdy, Y. Kim, N. Ahmadi, A. Luna, C. Luna, M. Rambod, A. R. Nissenson, M. J. Budoff, and K. Kalantar-Zadeh
Association of Serum Alkaline Phosphatase with Coronary Artery Calcification in Maintenance Hemodialysis Patients
Clin. J. Am. Soc. Nephrol., June 1, 2009; 4(6): 1106 - 1114.
[Abstract] [Full Text] [PDF]

Home page
 pdiHome page
A. Y.-M. Wang
VASCULAR AND OTHER TISSUE CALCIFICATION IN PERITONEAL DIALYSIS PATIENTS
Perit. Dial. Int., February 1, 2009; 29(Supplement_2): S9 - S14.
[Abstract] [Full Text] [PDF]

Home page
 pdiHome page
R. Shroff
MONITORING CARDIOVASCULAR RISK FACTORS IN CHILDREN ON DIALYSIS
Perit. Dial. Int., February 1, 2009; 29(Supplement_2): S173 - S175.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
T. Reinehr and C. L. Roth
Fetuin-A and Its Relation to Metabolic Syndrome and Fatty Liver Disease in Obese Children Before and After Weight Loss
J. Clin. Endocrinol. Metab., November 1, 2008; 93(11): 4479 - 4485.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.