Marek Kuźniewski1, Danuta Fedak2, Paulina Dumnicka3, Ewa Stępień4, Beata Kuśnierz-Cabala2, Marcin Cwynar5, Władysław Sułowicz1. 1. Chair and Department of Nephrology, Jagiellonian University Medical College, Kraków, Poland. 2. Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Kraków, Poland. 3. Department of Medical Diagnostics, Jagiellonian University Medical College, Kraków, Poland. Electronic address: paulina.dumnicka@uj.edu.pl. 4. Department of Medical Physics, M. Smoluchowski Institute of Physics, Jagiellonian University, Kraków, Poland. 5. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland.
Abstract
PURPOSE: The high prevalence of cardiovascular morbidity and mortality among patients with chronic kidney disease (CKD) is observed especially in those undergoing dialysis. Osteoprotegerin (OPG) and its ligands, receptor activator of nuclear factor kappa-B ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been associated with cardiovascular complications. Our aim was to study their role as cardiovascular risk factors in stage 5 CKD patients. PATIENTS AND METHODS: OPG, RANKL and TRAIL concentrations were measured in 69 hemodialyzed CKD patients and 35 healthy volunteers. In CKD patients, cardiovascular dysfunction was assessed with aortic pulse wave velocity (AoPWV), carotid artery intima-media thickness (CCA-IMT), coronary artery calcium score (CACS) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentrations. Cardiovascular and overall mortality data were collected during a 7-years follow-up. RESULTS: OPG plasma concentrations were higher in CKD patients comparing to controls. Total soluble RANKL was lower and OPG/RANKL ratio higher in patients. Soluble TRAIL concentrations did not differ between the groups and OPG/TRAIL ratio was higher in CKD patients. OPG and OPG/TRAIL positively predicted long-term mortality (all-cause and cardiovascular) in CKD patients. OPG positively correlated with AoPWV, CCA-IMT and NT-proBNP whereas OPG/TRAIL with AoPWV and NT-proBNP. Described relationships were independent of classical and non-classical cardiovascular risk factors, with exception of age. CONCLUSIONS: Our study confirmed the role of OPG as a biomarker of cardiovascular dysfunction and a predictor of mortality in stage 5 CKD. OPG/TRAIL ratio can be proposed as a predictor of cardiovascular dysfunction and mortality.
PURPOSE: The high prevalence of cardiovascular morbidity and mortality among patients with chronic kidney disease (CKD) is observed especially in those undergoing dialysis. Osteoprotegerin (OPG) and its ligands, receptor activator of nuclear factor kappa-B ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been associated with cardiovascular complications. Our aim was to study their role as cardiovascular risk factors in stage 5 CKDpatients. PATIENTS AND METHODS: OPG, RANKL and TRAIL concentrations were measured in 69 hemodialyzed CKDpatients and 35 healthy volunteers. In CKDpatients, cardiovascular dysfunction was assessed with aortic pulse wave velocity (AoPWV), carotid artery intima-media thickness (CCA-IMT), coronary artery calcium score (CACS) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentrations. Cardiovascular and overall mortality data were collected during a 7-years follow-up. RESULTS:OPG plasma concentrations were higher in CKDpatients comparing to controls. Total soluble RANKL was lower and OPG/RANKL ratio higher in patients. Soluble TRAIL concentrations did not differ between the groups and OPG/TRAIL ratio was higher in CKDpatients. OPG and OPG/TRAIL positively predicted long-term mortality (all-cause and cardiovascular) in CKDpatients. OPG positively correlated with AoPWV, CCA-IMT and NT-proBNP whereas OPG/TRAIL with AoPWV and NT-proBNP. Described relationships were independent of classical and non-classical cardiovascular risk factors, with exception of age. CONCLUSIONS: Our study confirmed the role of OPG as a biomarker of cardiovascular dysfunction and a predictor of mortality in stage 5 CKD. OPG/TRAIL ratio can be proposed as a predictor of cardiovascular dysfunction and mortality.
Authors: Marcela Ávila; Ma Del Carmen Prado; Renata Romero; Ricardo Córdova; Ma Del Carmen Rigo; Miguel Trejo; Carmen Mora; Ramón Paniagua Journal: Biomolecules Date: 2022-04-08
Authors: Lena Tschiderer; Gerhard Klingenschmid; Rajini Nagrani; Johann Willeit; Jari A Laukkanen; Georg Schett; Stefan Kiechl; Peter Willeit Journal: J Am Heart Assoc Date: 2018-08-21 Impact factor: 5.501