Vascular calcification in peritoneal dialysis patients and its association with bone-derived molecules and bone histomorphometry

• Type: Article in International Scientific Journal
• Date: 2024

Authors

Pereira, L (Author) Other; Mendonça, Luís (Author) FMUP; Magalhaes, J (Author) Other; Ricardo Neto (Author) FMUP; Quelhas-Santos, J (Author) FMUP; Oliveira, A (Author) Other; Beco, A (Author) Other; João Frazão (Author) FMUP

Journal

Title: Nefrologia

Vol. 44

Pages: 224-232

ISSN: 0211-6995

Publisher: Grupo Aula Medica S.A.

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-00X-WB9

DOI: 10.1016/j.nefro.2023.01.005

Abstract (EN): Introduction: Data regarding vascular calcification (VC) in contemporary peritoneal dialysis (PD) patients is scarce. Bone-vascular axis has been demonstrated in hemodialysis (HD). However, studies showing the link between bone disease and VC in PD patients are lacking. The role of sclerostin, dickkopf-related protein 1 (DKK-1), receptor activator for nuclear factor kB ligand and osteoprotegerin (OPG) in VC in PD remains to clarify. Materials and methods: Bone biopsy was performed in 47 prevalent PD patients with histomorphometric analysis. Patients were submitted to pelvis and hands X-ray to evaluate VC using the Adrag & atilde;o score (AS). Relevant clinical and biochemical data was collected. Results: Thirteen patients (27.7%) had positive AS (AS >= 1). Patients with VC were significantly older (58.9 vs. 50.4 years, p = 0.011), had a lower dialysis dose (KT/V 2.0 vs. 2.4, p = 0.025) and a higher glycosylated hemoglobin (7.2 vs. 5.4%, p = 0.001). There was not any laboratorial parameter of mineral and bone disease used in clinical practice different between patients with or without VC. All diabetic patients had VC but only 8.1% of non -diabetic had VC (p < 0.001). Patients with VC showed significantly higher erythrocyte sedimentation rate (ESR) (91.1 vs. 60.0 mm/h, p = 0.001), sclerostin (2250.0 vs. 1745.8 pg/mL, p = 0.035), DKK1 (1451.6 vs. 1042.9 pg/mL, p = 0.041) and OPG levels (2904.9 vs. 1518.2 pg/mL, p = 0.002). On multivariate analysis, only ESR remained statistically significant (OR 1.07; 95% CI 1.01-1.14; p = 0.022). Bone histomorphometric findings were not different in patients with VC. There was no correlation between bone formation rate and AS (r=-0.039; p = 0.796). Conclusion: The presence of VC was not associated with bone turnover and volume evaluated by bone histomorphometry. Inflammation and diabetes seem to play a more relevant role in VC in PD. (c) 2023 Sociedad Espa nola de Nefrolog & imath;a. Published by Elsevier Espa na, S.L.U. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9