Serum Osteoprotegerin Is Associated Independently with Peripheral Arterial Stiffness in Chronic Kidney Disease.

Background/

Objectives

Patients with chronic kidney disease (CKD) often present with peripheral arterial stiffness (PAS), which is associated with an increased cardiovascular risk. This study assessed the association between circulating osteoprotegerin (OPG), a known mediator of vascular calcification, and PAS, measured as brachial-ankle pulse wave velocity (baPWV), in patients with CKD.

Methods

This cross-sectional investigation engaged 200 individuals with non-dialysis CKD. Serum OPG concentrations were measured using a commercial enzyme-linked immunosorbent assay. Participants were classified as having PAS when either left or right baPWV was greater than 18.0 m/s; those with baPWV values of 18.0 m/s or lower were assigned to the control group.

Results

Eighty-six patients (43.0%) had PAS. In comparison to controls, PAS patients were older (p < 0.001) and had higher proportions of diabetes mellitus (p = 0.023) and hypertension (p = 0.010); systolic blood pressure was higher (p < 0.001), urine protein-to-creatinine ratio was elevated (p = 0.004), and serum OPG was markedly greater (p < 0.001), whereas estimated glomerular filtration rate was lower (p = 0.003). After full adjustment, OPG levels, in addition to older age and diabetes mellitus, demonstrated an independent association with PAS (odds ratio: 1.008; 95% confidence interval: 1.002-1.015; p = 0.010). The OPG level was positively associated with bilateral baPWV by Spearman's correlation analysis (p < 0.001).

Conclusions

Circulating OPG level showed an independent association with PAS and baPWV in CKD patients not yet on dialysis. Hence, OPG can be a potential marker of vascular risk in this patient population.