Hermans M M H, Brandenburg V, Ketteler M, Kooman J P, van der Sande F M, Boeschoten E W, Leunissen K M L, Krediet R T, Dekker F W
Department of Internal Medicine and Nephrology, Academic Hospital Maastricht, Maastricht, The Netherlands.
Kidney Int. 2007 Jul;72(2):202-7. doi: 10.1038/sj.ki.5002178. Epub 2007 Mar 7.
Calcifying atherosclerosis is an active process, which is controlled by calcification inhibitors and inducers. Fetuin-A, an acute phase glycoprotein, is one of the more powerful circulating inhibitors of hydroxyapatite formation. A prospective multicenter cohort study was initiated to include both hemodialysis (HD) and peritoneal dialysis (PD) patients in an evaluation of the association of serum fetuin-A levels with both cardiovascular (CV) and non-CV mortality. An increase in the serum fetuin-A concentration of 0.1 g/l was associated with a significant reduction in all-cause mortality of 13%. There was a significant 17% reduction in non-CV mortality and a near significant reduction in CV mortality. This association of fetuin-A and mortality rates was comparable in both HD and PD patients even when corrected for factors, including but not limited to age, gender, primary kidney disease, C-reactive protein levels, and nutritional status. We conclude that serum fetuin-A concentrations may be a general predictor of mortality in dialysis patients.
钙化性动脉粥样硬化是一个活跃的过程，受钙化抑制剂和诱导剂的控制。胎球蛋白-A是一种急性期糖蛋白，是羟基磷灰石形成的较强循环抑制剂之一。一项前瞻性多中心队列研究启动，纳入血液透析（HD）和腹膜透析（PD）患者，以评估血清胎球蛋白-A水平与心血管（CV）和非CV死亡率之间的关联。血清胎球蛋白-A浓度每增加0.1 g/l，全因死亡率显著降低13%。非CV死亡率显著降低17%，CV死亡率接近显著降低。即使校正了包括但不限于年龄、性别、原发性肾病、C反应蛋白水平和营养状况等因素，胎球蛋白-A与死亡率之间的这种关联在HD和PD患者中也是相当的。我们得出结论，血清胎球蛋白-A浓度可能是透析患者死亡率的一个通用预测指标。
