Publication
Title
Sclerostin : another bone-related protein related to all-cause mortality in haemodialysis?
Author
Abstract
Background Derangements in bone metabolism and vascular calcification (VC) substantially contribute to the accelerated cardiovascular morbidity and mortality in chronic kidney disease (CKD). The Wnt signalling pathway is increasingly recognized to play an important role in bone homeostasis and VC. Circulating levels of the Wnt inhibitor sclerostin are elevated in CKD patients. The present study investigated whether the circulating levels of sclerostin are associated with all-cause mortality in haemodialysis (HD) patients. Methods We performed a post-hoc survival analysis in 100 prevalent HD patients (68 ± 13 years, 40 male) recruited in 2006 who were prospectively followed for median 637 (81000, range) days. Parameters of mineral metabolism including bone-specific alkaline phosphatase (bsAP) and serum sclerostin were determined in spare blood samples collected at baseline. Results Serum concentrations of serum sclerostin amounted to 110 (82151) [median (iqr)] pmol/L. Patients with sclerostin levels above median were characterized by older age, higher haemoglobin and creatinine level and lower bsAP concentration. During a median follow-up of 637 days, 31 patients died. Higher circulating sclerostin levels were associated with decreased mortality in prevalent HD patients: unadjusted hazard ratio (HR) 0.51 (0.241.06) (P = 0.06); HR adjusted for age and gender for serum sclerostin levels above versus below median was 0.33 (0.150.73) (P = 0.006). When bsAP was entered in the Cox regression analysis, it replaced sclerostin in the final model. Conclusions Our data show that high circulating sclerostin levels are associated with improved survival and suggest that a low bsAP activity may be in the causal pathway.
Language
English
Source (journal)
Nephrology, dialysis, transplantation. - Berlin
Publication
Berlin : 2013
ISSN
0931-0509
Volume/pages
28:12(2013), p. 3024-3030
ISI
000327798600014
Full text (Publisher's DOI)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 14.11.2013
Last edited 10.09.2017
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