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Abstract: PO1801

Serum Cathepsin-S Concentration Is Not Related to Arterial Calcification Severity Among Hemodialysis Patients

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials


  • Ma, Hao-Wei, Taipei Veterans General Hospital, Taipei, Taiwan
  • Lin, Chih-Ching, Taipei Veterans General Hospital, Taipei, Taiwan
  • Li, Szu-Yuan, Taipei Veterans General Hospital, Taipei, Taiwan

Vascular calcification is prevalent among hemodialysis patients and is strongly correlated to their cardiovascular and total mortality. Cathepsin S, a lysosomal cysteine protease that is elevated in CKD patients, has shown its critical role of vascular calcification in cell culture experiments and in uremic animal model. To validate the relationship of Cathepsin S and vascular calcification in clinical practice, we conducted the current cross sectional study.


88 patients on maintenance hemodialysis were enrolled and their serum Cathepsin S and its natural inhibitor Cystatin C were measured. Severity of vascular calcification was semi-quantified by aortic arch calcification (AAC) score on chest X-rays. Patients were divided into groups according to their AAC score, and the serum Cathepsin S level, Cathepsin S / Cystatin C ratio and other factors were compared between groups.


There was no significant difference in the level of Cathepsin S (p=0.778) or Cathepsin S to Cystatin C ratio (p=0.417) between patients with different aortic arch calcification score. Only age was associated with the severity of AAC score (p=0.014). Increasing serum triglyceride level is significantly associated with higher serum Cathepsin S level (Pearson Correlation p=0.001, R square=0.133).


Despite a pre-clinical study supporting the role of Cathepsin S in the development of vascular calcification under uremic and phosphate-rich conditions, serum Cathepsin S was not found to be associated with vascular calcification severity among hemodialysis patients in this study. Serum triglyceride is the strongest predicting factor for higher Cathepsin S levels in these patients. Further study is needed to confirm these findings using a different grading system.

Mean age and serum Cathepsin S with 95% confidence interval between groups of patients, categorized by their Aortic arch calcification (AAC) grade.