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Abstract: PO0605

Association of Serum Sclerostin Levels with Mortality in Maintenance Hemodialysis Patients: An 8-Year Prospective Cohort Study

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Nakagawa, Yosuke, Tokai Daigaku, Isehara, Kanagawa, Japan
  • Komaba, Hirotaka, Tokai Daigaku, Isehara, Kanagawa, Japan
  • Wada, Takehiko, Tokai Daigaku, Isehara, Kanagawa, Japan
  • Kakuta, Takatoshi, Tokai Daigaku Igakubu Fuzoku Hachioji Byoin, Hachioji, Tokyo, Japan
  • Fukagawa, Masafumi, Tokai Daigaku, Isehara, Kanagawa, Japan
Background

Sclerostin is an osteocyte-derived inhibitor of bone formation and is increased in kidney failure. Sclerostin might be involved in the pathogenesis of vascular calcification, but few studies examined the association between sclerostin and mortality in hemodialysis patients.

Methods

We analyzed a cohort of 654 maintenance hemodialysis patients enrolled in the Tokai Dialysis Prospective Cohort Study. The primary exposure variable was the baseline serum sclerostin level, measured using a sandwich ELISA (Biomedica Medizinprodukte GmbH & Co KG). The primary outcome was 8-year all-cause mortality. Mortality risk was assessed using Cox regression models adjusted for potential confounders.

Results

aseline median (IQR) serum sclerostin level was 163 (120-215) pmol/L. Patients with higher sclerostin levels were likely to be male; have diabetes; have better nutritional status, higher hemoglobin, and lower intact PTH and bone turnover markers. No associations were observed between serum sclerostin and cardiovascular comorbidities. During a median follow-up of 7.6 years (IQR, 4.1-8.0 years), 229 of the 654 participants died. In univariate analysis, serum sclerostin levels were not associated with mortality (HR per doubling, 0.94; 95% CI, 0.76-1.17). This result was unchanged after adjustment for age, sex, dialysis vintage, diabetes, prior cardiovascular disease, body mass index, hemoglobin, albumin, and creatinine (HR per doubling, 1.07; 95% CI, 0.82-1.40).

Conclusion

Serum sclerostin levels were not associated with mortality in maintenance hemodialysis patients. Further research is required to determine the role of sclerostin in vascular calcification and cardiovascular disease in kidney failure.

Funding

  • Government Support – Non-U.S.