Relationship of sRANKL level and vascular calcification score to cardiovascular events in maintenance hemodialysis patients.

BACKGROUND

Vascular calcification and cardiovascular events are common in hemodialysis patients. Receptor activator of nuclear factor-kappaB ligand (RANKL) plays an important role in vascular calcification and bone remodeling. This study investigates the effects of soluble RANKL (sRANKL) on cardiovascular events in hemodialysis patients.

METHODS

Serum sRANKL levels of 47 patients were tested by ELISA. Vascular calcification was radiographically measured and patients were followed up for 2 years.

RESULTS

After 2 years, 10 (36.6%) patients had experienced cardiovascular events. Seventy-five percent (6/9) of mortality was due to cardiovascular disease. Patients experiencing cardiovascular events showed significantly higher vascular calcification scores (VCS) (3.20 +/- 2.74 vs. 1.19 +/- 1.60; t = 2.999; p < 0.05). Multivariate regression analysis showed that serum sRANKL levels, vascular calcification scores and phosphorus were independent determinants of cardiovascular events.

CONCLUSION

Serum sRANKL levels and VCS are independent risk factors, and hemodialysis patients with low serum sRANKL levels have a risk of cardiovascular events.