Fetuin-A is an independent determinant of change of aortic stiffness over 1 year in non-diabetic patients with CKD stages 3 and 4

Ford, Martin L, Tomlinson, Laurie A, Smith, Edward R, Rajkumar, Chakravarthi and Holt, Stephen G (2010) Fetuin-A is an independent determinant of change of aortic stiffness over 1 year in non-diabetic patients with CKD stages 3 and 4. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association - European Renal Association, 25 (6). pp. 1853-1858. ISSN 1460-2385

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Abstract

BACKGROUND
Vascular calcification is highly prevalent in chronic kidney disease (CKD) patients. This calcification leads to arterial stiffening. Fetuin-A is an endogenous inhibitor of vascular calcification and has been associated with arterial stiffness and mortality in dialysis patients. We tested the relationship between fetuin-A and change in arterial stiffness in CKD stages 3 and 4.

METHODS
We measured fetuin-A concentrations in 92 patients with CKD stages 3 and 4 and studied the association with clinical, biochemical and vascular parameters including arterial stiffness measured by carotid-femoral pulse wave velocity (PWV) at 0 and 12 months.

RESULTS
Fetuin-A was significantly lower in the non-diabetic group (n = 73) compared to the diabetic group (n = 19, P = 0.018). There was a significant interaction between diabetic status and fetuin-A concentration. Univariate analysis of the non-diabetic group showed association between change in aortic stiffness over 1 year with fetuin-A (r = -0.481, P < 0.0001) and systolic blood pressure (r = 0.389, P = 0.001) and baseline PWV (r = 0.240, P = 0.041). In multivariate analysis, fetuin-A, systolic blood pressure and baseline PWV independently predicted change in carotid-femoral PWV at 1 year (beta = -0.355, P = or< 0.001; beta = 0.426, P < 0.001; and beta = -0.383, P < 0.001, respectively; model R(2) = 0.455).

CONCLUSIONS
In patients with non-diabetic CKD stages 3 and 4, fetuin-A is an independent risk factor for progressive arterial stiffness.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Subjects: R Medicine > RC Internal medicine > RC0581 Specialties of internal medicine > RC0952 Geriatrics
Depositing User: Simone Breckell
Date Deposited: 30 Oct 2012 15:51
Last Modified: 30 Oct 2012 15:51
URI: http://sro.sussex.ac.uk/id/eprint/41696
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