Abstract: SA-PO846

Serum Sclerostin Level Is an Independent Predictor of Short-Term Mortality in Maintenance Hemodialysis Patients

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • Nitta, Kosaku, Tokyo Women's Medical University, Shinjuku-ku, TOKYO, Japan
  • Tsuchiya, Ken, Tokyo Women's Medical University, Shinjuku-ku, TOKYO, Japan
Background

Sclerostin has recently been recognized as a novel marker of bone remodeling and vascular calcification. However, whether a high circulating sclerostin level is also a risk factor for death has not been clearly established. The aim of this study was to determine whether there is an association between the serum sclerostin levels and their mortality of maintenance hemodialysis (MHD) patients.

Methods

We measured the serum sclerostin levels in a Japanese MHD cohort, and followed over a 4-year period, and classified the patients into tertiles according to their serum sclerostin levels. We then assessed their short-term mortality (16 months) and long-term mortality (42 months) according to their serum sclerostin levels. Cox regression analyses were performed to test for associations between their serum sclerostin levels and both all-causemortality and cardiovascular disease (CVD)-related mortality. Kaplan-Meier curves were used to perform the survival analyses.

Results

The cohort consisted of 389 MHD patients aged 42.3 ± 18.8 years (55% males, 15% diabetics). There were 75 deaths during the follow-up period of 38.2 ± 9.3 months, 75 patients died. The main cause of death was CVD (n = 31), and was followed by infection (n = 30). The results of the multivariate logistic regression adjusted for confounders showed that history of CVD (HR 3.34, 95% CI 1.219 – 8.255, P = 0.0209) was the only significant predictor of all-cause mortality, but the serum tryglyceride level (HR 0.002, 95% CI 0.002 – 0.594, P = 0.0305) and being in the 1st tertile of sclerostin levels (HR 8.791, 95% CI 1.574 – 164.808, P = 0.0098) were significant predictors of CVD-related mortality during the 16 month-follow-up period. Kaplan-Meier analyses showed no significant differences in CVD-related mortality between tertiles during 16 month-follow-up period, but higher mortality in the 1st tertile (P = 0.0274). There were no significant differences in all-cause or CVD-related mortality tertiles during the 42 month-follow-up period.

Conclusion

The serum sclerostin level is an independent predictor of short-term mortality in MHD patients, but whether clinical interventions to modulate their serum sclerostin levels would improve their survival remains to be determined.