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NDT Advance Access published online on May 26, 2005
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh879
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received October 23, 2004
Accepted April 8, 2005

Original Articles

Predictive value of serum macrophage colony-stimulating factor for development of aortic calcification in haemodialysis patients: a 6 year longitudinal study

Toshiharu Kihara 1, Yasuyoshi Miyata 1*, Masataka Furukawa 1, Mitsuru Noguchi 1, Masaharu Nishikido 1, Shigehiko Koga 1, and Hiroshi Kanetake 1

1 Division of Nephro-Urology, Department of Translational Medical Science, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan

* To whom correspondence should be addressed.
Yasuyoshi Miyata, E-mail: int.doc.miya{at}m3.dion.ne.jp



  Abstract

Background. Accelerated atherosclerosis is a major complication in patients on haemodialysis (HD). Macrophage colony-stimulating factor (MCSF) is a representative regulator of activation of monocytes and macrophages, and plays important roles in the development of atherosclerosis in HD patients. However, the long-term predictive value of the serum MCSF level for the development of aortic calcification under HD conditions has not been reported.

Methods. Serum MCSF level was measured in 40 HD patients. The aortic calcification index (ACI) was also calculated on computed tomography once each year for 6 years. Predictive value was examined by logistic regression analysis.

Results. At baseline, there was a significant correlation between serum MCSF and ACI (r = 0.43, P<0.01). A significant increase in ACI was first noted at 4 years post-baseline and the increase was maintained thereafter in the high MCSF group. No such changes were noted in the low MCSF group. Univariate analysis identified high levels of calcium x phosphorus product, triglyceride, C-reactive protein (CRP), MCSF and presence of diabetes mellitus as significant predictors for increased ACI at 6 years. However, among these five factors, high levels of CRP and MCSF were the only independent and significant predictors (odds ratio = 24.0, P = 0.03 and odds ratio = 22.8, P = 0.02, respectively).

Conclusions. Our results demonstrated that MCSF is associated with the process of atherosclerosis in HD patients. Furthermore, the serum MCSF level is an independent long-term predictor of increased ACI. These results provide useful information for preventive strategies against atherosclerotic disease under HD conditions.

Keywords: aortic calcification index; atherosclerosis; haemodialysis; logistic regression analysis; longitudinal study; macrophage colony-stimulating factor.
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