Sclerostin Quo Vadis? - Is This a Useful Long-Term Mortality Parameter in Prevalent Hemodialysis Patients?

Autor: Albina Nowak, Ferruh Artunc, Andreas L. Serra, Emily Pollock, Pierre-Alexandre Krayenbühl, Christian Müller, Björn Friedrich
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Kidney & Blood Pressure Research, Vol 40, Iss 3, Pp 266-276 (2015)
Druh dokumentu: article
ISSN: 1420-4096
1423-0143
DOI: 10.1159/000368502
Popis: Background/Aims: Cardiovascular calcification contributes to the increased mortality in hemodialysis patients. Sclerostin was identified as an antianabolic bone factor causing soft tissue calcification. Data on prospective large-scale studies associating sclerostin with mortality in hemodialysis patients are so far inconsistent. Methods: In our multicenter prospective longitudinal study following hemodialysis patients, we assessed the associations of sclerostin and bone remodeling markers with long-term mortality. We evaluated the relationship between circulating sclerostin, Fibroblast growth factor 23 (FGF23) and traditional bone remodeling markers. Sclerostin levels in hemodialysis patients were compared with healthy controls. Results: We enrolled 239 hemodialysis patients with a median follow up of 1461 days. In Cox regression analysis, FGF23 (HR 1.40;95%CI 1.11-1.76), parathyroid hormone (PTH) (HR 1.80;95%CI 1.44-2.26) and alkaline phosphatase (AP) (HR 1.50;95%CI 1.10-2.04) per SD, 25(OH)vitamin D (HR 0.42;95%CI 0.23-0.76) per natural log but not sclerostin (HR 1.02;95%CI 0.75-1.38) per SD increase were associated with mortality. FGF23, PTH and AP were negatively associated with sclerostin. Among control and hemodialysis females, sclerostin levels were lower than in men. Conclusion: Higher FGF23, PTH, AP and lower 25(OH)vitamin D but not sclerostin predict long-term mortality. Sclerostin was negatively associated with FGF23, PTH and AP and lower in females than in males.
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