Author/Editor		Pečovnik-Balon, Breda; Knehtl, Maša; Bevc, Sebastjan; Jakopin, Eva; Gorenjak, Maksimiljan
Title		Fetuin-A as a risk factor for mortality in hemodialysis patients
Type		članek
Source		Wien Klin Wochenschr Suppl
Vol. and No.		Letnik 122, št. 2
Publication year		2010
Volume		str. 63-7
Language		eng
Abstract		Objectives: Fetuin A, a circulating inhibitor of calcification, is regulated as a negative acute-phase protein. However, its relationship with outcomes of patients undergoing hemodialysis has not been well evaluated. The aim of our study was to determine the association between fetuin-A and some factors of metabolism and their impact on all-cause mortality in hemodialysis patients. Patients and methods: The study comprised 106 hemodialysis patients, 45 of whom were women. Levels of serum fetuin-A were measured by ELISA and serum intact parathyroid hormone (iPTH) by immunoassay in each patient. Serum Ca, serum P, Ca x P product, alkaline phosphatase, cholesterol, triglycerides, bicarbonate, albumin, homocysteine and C-reactive protein (CRP) were measured using routine laboratory methods. Survival rates were analyzed using Kaplan-Meier survival curves. A Cox regression model was used to access the possible infl uence of variables on all-cause mortality. Results: The mean value of fetuin-A was 15.3 +/- 3.8 g/l, range 5.5-23.7 g/l. Significant correlations were found between serum fetuin-A and serum iPTH (r=-0.239; P =0.014), alkaline phosphatase (r=-0.240; P=0.013), triglycerides (r=+0.236; P=0.015) and serum albumin level (r=+0.286; P=0.003). Patients were followed-up prospectively from the first day of the laboratory measurement for a maximum of 752 days or until death. A total of 24 patients died. Surviving patients had higher levels of fetuin-A (P=0.005), serum cholesterol (P=0.0001), triglycerides (P=0.004), albumin (P=0.0001) and homocysteine (P=0.028). Kaplan-Meier survival analysis showed higher mortality in the fi rst tertile of fetuin-A than in the third tertile (P= 0.0297). In our patients, serum Ca (P=0.025), serum P (P=0.040) and the Ca x P product (P=0.039) were found to be predictors of mortality in the Cox multivariable regression model. (Abs. trunc. at 2000 ch.)
Descriptors		CALCIFICATION, PHYSIOLOGIC CALCIUM PHOSPHORUS MORTALITY