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Serum calcification propensity predicts all-cause mortality in predialysis CKD.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Smith, Edward R. Ford, Martin L. Tomlinson, Laurie A. Bodenham, Emma McMahon, Lawrence P. Farese, Stefan Rajkumar, Chakravarthi Holt, Stephen G. Pasch, Andreas
Description	Author Affiliation: Smith ER ( Department of Renal Medicine, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia)
Abstract	Medial arterial calcification is accelerated in patients with CKD and strongly associated with increased arterial rigidity and cardiovascular mortality. Recently, a novel in vitro blood test that provides an overall measure of calcification propensity by monitoring the maturation time (T50) of calciprotein particles in serum was described. We used this test to measure serum T50 in a prospective cohort of 184 patients with stages 3 and 4 CKD, with a median of 5.3 years of follow-up. At baseline, the major determinants of serum calcification propensity included higher serum phosphate, ionized calcium, increased bone osteoclastic activity, and lower free fetuin-A, plasma pyrophosphate, and albumin concentrations, which accounted for 49% of the variation in this parameter. Increased serum calcification propensity at baseline independently associated with aortic pulse wave velocity in the complete cohort and progressive aortic stiffening over 30 months in a subgroup of 93 patients. After adjustment for demographic, renal, cardiovascular, and biochemical covariates, including serum phosphate, risk of death among patients in the lowest T50 tertile was more than two times the risk among patients in the highest T50 tertile (adjusted hazard ratio, 2.2; 95% confidence interval, 1.1 to 5.4; P=0.04). This effect was lost, however, after additional adjustment for aortic stiffness, suggesting a shared causal pathway. Longitudinally, serum calcification propensity measurements remained temporally stable (intraclass correlation=0.81). These results suggest that serum T50 may be helpful as a biomarker in designing methods to improve defenses against vascular calcification.
File Format	HTM / HTML
ISSN	10466673
e-ISSN	15333450
DOI	10.1681/ASN.2013060635
Journal	Journal of the American Society of Nephrology
Issue Number	2
Volume Number	25
Language	English
Publisher	American Society of Nephrology
Publisher Date	2014-02-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Nephrology Arteriosclerosis Blood Calcinosis Calcium Phosphates Mortality Phosphates Renal Insufficiency, Chronic Serum Albumin Alpha-2-hs-glycoprotein Epidemiology Biological Markers Cardiovascular Diseases Causality Comorbidity Diabetes Mellitus Diphosphates Disease Susceptibility Hypertension Osteoclasts Metabolism Prospective Studies Pulse Wave Analysis Renal Dialysis Therapy Smoking Vascular Resistance Chemistry Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Nephrology

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