Fetuin-A, coronary artery calcification and outcome in maintenance hemodialysis patients

초록

Background/Aims: Previous studies have suggested that serum fetuin-A, a calcification inhibitor, predicts mortality in dialysis patients. This study investigated the relationships between fetuin-A, vascular calcification, and outcome in such patients. Methods: 58 patients on maintenance hemodialysis underwent multirow spiral computed tomography to determine baseline coronary artery calcification (CAC) score. Serum fetuin-A was measured repeatedly over time. Results: Time-averaged fetuin-A inversely correlated with age and baseline CAC score. After partial correlation analysis controlling for age, the association between fetuin-A and CAC became insignificant. During the study, 27 of 58 patients died and 26 experienced at least one cardiovascular event. Low fetuin-A was associated with a significant increase in all-cause mortality and the occurrence of a cardiovascular event. The association of fetuin-A with mortality and cardiovascular event remained significant even when adjusting for confounding factors, including age and CAC score. Conclusion: Time-averaged fetuin-A was associated with survival and cardiovascular outcome, independent of vascular calcification.

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