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Abstract: FR-PO178

CPP (Calciprotein Particle) Is a More Sensitive Marker That Predicts Vascular Calcification in Patients with CKD

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Moriya, Hidekazu, Shonan Kamakura General Hospital, Kamakura, KANAGAWA, Japan
  • Mochida, Yasuhiro, Shonan Kamakura General Hospital, Kamakura, KANAGAWA, Japan
  • Ishioka, Kunihiro, Shonan Kamakura General Hospital, Kamakura, KANAGAWA, Japan
  • Hidaka, Sumi, Shonan Kamakura General Hospital, Kamakura, KANAGAWA, Japan
  • Ohtake, Takayasu, Shonan Kamakura General Hospital, Kamakura, KANAGAWA, Japan
  • Kobayashi, Shuzo, Shonan Kamakura General Hospital, Kamakura, KANAGAWA, Japan
Background

Vascular calcification in atherosclerotic diseases is an important issue related to the prognosis in patients with chronic kidney disease (CKD). Since vascular calcification occurs in an early stage of CKD, it should be evaluated to improve the prognosis by early intervention. Phosphorus, parathyroid hormone and FGF-23 are identified as markers of CKD-mineral bone disease, but are within normal range in an early stage of CKD.
CPP stands for calciprotein particles, which are nanoparticles composed of calcium-phosphate (CaP) crystals and mineral binding proteins such as Fetuin-A. Serum CPP levels could be a useful marker of vascular calcification in an early CKD patients.
In this study, we determined whether CPP is a more sensitive marker of vascular calcification of patients with CKD than existing markers.

Methods

In a single-center longitudinal study of 58 patients with CKD stage G1-5, we evaluated clinical parameters (s-Cr, eGFR, CPP, FGF-23, intact-PTH, 1.25 VitD) and arterial calcification score (ACS) of lower extremities by MDCT at the start and one year later to determine the risk factors related to the development of vascular calcification in CKD.

Results

Average age and average s-Cr were 69.0±12.9 years and 1.78±1.26mg/dl, respectively. CPP significantly correlated with serum phosphorus but not with s-Cr or eGFR. The rate of change in s-Cr, eGFR, FGF-23, intact-PHT, and 1.25 VitD did not show significant correlation with the rate of change in ACS of the lower extremities, but the rate of change in CPP showed significantly negative correlation with the rate of change in ACS (r = -0.292, P = 0.0258), and the rate of change in CPP was also an independent risk factor (p = 0.0144) in the progression of vascular calcification in multivariate analysis.

Conclusion

CPP effects protectively for vascular calcification by capturing calcium and phosphorus. CPP is a more sensitive marker of arterial calcification than other CKD-MBD markers such as FGF-23.