Osteoprotegerin Is a Better Predictor for Cardiovascular and All-Cause Mortality than Vascular Calcifications in a Multicenter Cohort of Patients on Peritoneal Dialysis

• Published in: Biomolecules (Basel, Switzerland) Switzerland), 2022-04, Vol.12 (4), p.551
• Main Authors: Ávila, Marcela, Prado, Ma Del Carmen, Romero, Renata, Córdova, Ricardo, Rigo, Ma Del Carmen, Trejo, Miguel, Mora, Carmen, Paniagua, Ramón, For The Mexican Nephrology Collaborative Study Group
• Format: Article
• Language: English
• Subjects: Adult; Albumin; Albumins; Alkaline phosphatase; Angina pectoris; Biochemical markers; Biomarkers; Calcification; Calcification (ectopic); Calcium; Cardiovascular disease; Cardiovascular Diseases; cardiovascular mortality; Computed tomography; Coronary vessels; Creatinine; diabetes mellitus; Female; Heart attacks; Heart failure; Humans; Ligands; Male; Metabolism; Middle Aged; Mortality; Normal distribution; Osteocalcin; Osteoprotegerin; Patients; Peritoneal dialysis; Peritoneal Dialysis - adverse effects; Peritoneum; risk factor; Risk Factors; Specialty products; Tomography; Tumor necrosis factor-TNF; Variables; Vascular Calcification
• ISSN: 2218-273X; 2218-273X
• DOI: 10.3390/biom12040551

The purpose of this study was to compare vascular calcification (VC), serum osteoprotegerin (OPG) levels, and other biochemical markers to determine their value as available predictors of all-cause and cardiovascular (CV) mortality in patients on peritoneal dialysis (PD). A total of 197 patients were recruited from seven dialysis centers in Mexico City. VC was assessed with multi-slice computed tomography, measured using the calcification score (CaSc). OPG, albumin, calcium, hsC-reactive protein, phosphorous, osteocalcin, total alkaline phosphatase, and intact parathormone were also analyzed. Follow-up and mortality analyses were assessed using the Cox regression model. The mean age was 43.9 ± 12.9 years, 64% were males, and 53% were diabetics. The median OPG was 11.28 (IQR: 7.6−17.4 pmol/L), and 42% of cases had cardiovascular calcifications. The median VC was 424 (IQR:101−886). During follow-up (23 ± 7 months), there were 34 deaths, and 44% were cardiovascular in origin. In multivariable analysis, OPG was a significant predictor for all-cause (HR 1.08; p < 0.002) and CV mortality (HR 1.09; p < 0.013), and performed better than VC (HR 1.00; p < 0.62 for all-cause mortality and HR 1.00; p < 0.16 for CV mortality). For each mg/dL of albumin-corrected calcium, there was an increased risk for CV mortality, and each g/dL of albumin decreased the risk factor for all-cause mortality. OPG levels above 14.37 and 13.57 pmol/L showed the highest predictive value for all-cause and CV mortality in incident PD patients and performed better than VC.