Osteoprotegerin and Progression of Coronary and Aortic Calcifications in Chronic Kidney Disease

• Published in: Transplantation proceedings 2010-11, Vol.42 (9), p.3444-3449
• Main Authors: Mesquita, M, Demulder, A, Wolff, F, Mélot, C, Damry, N, Dratwa, M, Bergmann, P
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aortic Diseases - blood; Aortic Diseases - diagnostic imaging; Aortic Diseases - etiology; Belgium; Biological and medical sciences; Biomarkers - blood; Calcinosis - blood; Calcinosis - diagnostic imaging; Calcinosis - etiology; Cardiology. Vascular system; Coronary Artery Disease - blood; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - etiology; Coronary heart disease; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Heart; Humans; Kidney Diseases - blood; Kidney Diseases - complications; Kidney Diseases - therapy; Kidney Transplantation; Least-Squares Analysis; Linear Models; Longitudinal Studies; Male; Medical sciences; Middle Aged; Osteoprotegerin - blood; Prognosis; Renal Dialysis; Severity of Illness Index; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue, organ and graft immunology; Tomography, X-Ray Computed
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.09.129

Abstract Vascular calcifications (VCs) are important predictors of cardiovascular mortality in patients with chronic kidney disease (CKD). We have shown previously that osteoprotegerin (OPG), a potential early biomarker for VC, was an independent predictor of mortality in CKD patients. The aim of our study was to follow longitudinally coronary and aortic VCs. VCs were measured using Siemens 16 detector CT in a group of predialysis and hemodialyzed patients before and after a follow-up of 4 years. Some of these patients were transplanted in the meantime. Renal function, calcium, phosphate, iPTH, hs-CRP (high sensitive protein C reactive), and OPG serum levels were also compared. VCs progressed in predialysis, hemodialyzed, and transplanted patients but the progression was not the same in all arterial beds. A progression of coronary calcifications was observed in predialysis and transplanted patients, while aortic calcifications worsened significantly only in hemodialyzed patients. OPG serum levels and hs-CRP were significantly lower among transplanted patients. We concluded that VC depends on the severity of the kidney disease. Transplanted patients are not protected from VC, yet their OPG serum levels were significantly lower, suggesting that there is no link between between OPG levels and severity of VC. Longer follow-up of these patients would be necessary to assess whether a decline in OPG correlates with better survival.