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NDT Advance Access originally published online on August 18, 2006
Nephrology Dialysis Transplantation 2007 22(1):290-291; doi:10.1093/ndt/gfl499
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Decreased serum fetuin-A levels after a single haemodialysis session

Email: mariocozzolino{at}hotmail.com

Sir,

Cardiovascular disease (CVD) is the leading cause of mortality in haemodialysis (HD) [1]. Elevated incidence of vascular calcification (VC) is observed in HD. Fetuin-A (AHSG, {alpha}2-Heremans–Schimd glycoprotein) is an important inhibitor of VC [2]. Reduced serum fetuin-A levels are associated with inflammation and increased CV mortality in HD [3]. In this study, we examined the effects of a single haemodialysis session on serum fetuin-A levels and other markers of inflammation, such as C-reactive protein (CRP), fibrinogen and albumin. We evaluated 20 clinically stable patients (40% males), aged 67 ± 12.8 years, with an HD vintage >9 months, 50% in standard bicarbonate-HD and 50% in haemodiafiltration (HDF). Serum levels of fetuin-A, CRP, fibrinogen and albumin were measured at the beginning and at the end of a 4-h HD session. Table 1 shows that serum CRP, fibrinogen and albumin levels did not change during the HD session. In contrast, serum fetuin-A levels decreased significantly after 4 h of HD (P = 0.027). We did not observe significant differences in serum fetuin-A levels between patients treated with standard bicarbonate-HD and HDF. The present study confirms that HD patients have reduced serum fetuin-A levels compared with the normal population. Furthermore, serum levels of fetuin-A decreased during a single HD session. Inflammation is one of the most important non-traditional cardiovascular risk factors associated with VC in HD patients. The inflammatory processes induced by HD treatment might contribute to reduced fetuin-A levels and therefore to increased mortality, even if this process does not seem to be improved by convective treatment.


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  		Table 1. Inflammatory markers during a single HD session

 
Conflict of interest statement. None declared.

Mario Cozzolino1, Andrea Galassi1, Maria Luisa Biondi1, Alessandra Butti1, Micol Russo2, Carlo Longhini2, Maurizio Gallieni1 and Diego Brancaccio1

1Renal Division
S. Paolo Hospital
University of Milan
Milan
Italy
2Chair of Internal Medicine
University of Ferrara
Ferrara
Italy

References

  1. Foley RN and Parfrey PS. (1998) Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32:Suppl 3, S112–S119.[Web of Science][Medline]
  2. Cozzolino M, Brancaccio D, Gallieni M, Slatopolsky E. (2005) Pathogenesis of vascular calcification in chronic kidney disease. Kidney Int 68:429–436.[CrossRef][Web of Science][Medline]
  3. Ketteler M, Bongartz P, Westenfeld R, et al. (2003) Association of low fetuin-A (AHSG) concentrations in serum with cardiovascular mortality in patients on dialysis: a cross-sectional study. Lancet 361:827–833.[CrossRef][Web of Science][Medline]

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This Article
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