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Long-term follow-up of biomarkers of vascular calcification after switch from traditional hemodialysis to online hemodiafiltration
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Nephrology. Tallinn Univ Technol, Estonia.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Nephrology.
Maastricht Univ, Netherlands.
Maastricht Univ, Netherlands.
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2019 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 79, no 3, p. 174-181Article in journal (Refereed) Published
Abstract [en]

Rapid progression of vascular calcification (VC) in hemodialysis (HD) patients is caused by several factors including inflammation and an imbalance between active inducers and inhibitors of VC. Growing evidence shows that online hemodiafiltration (ol-HDF), a combination of diffusive and convective solute transport, has positive effects on the uremic environment that affects patients on dialysis. However, we recently reported that serum 25-hydroxyvitamin D (25(OH)D) decreased after a switch from HD to ol-HDF. As a consequence of this finding, the present study was undertaken to investigate if inducers and inhibitors of VC (i.e. the inactive matrix Gla protein fractions dp-ucMGP and t-ucMGP, fetuin-A, Gla-rich protein (GRP), osteopontin (OPN), bone-specific alkaline phosphatase (BALP), and osteoprotegerin (OPG)) also are affected by ol-HDF. This non-comparative prospective study comprised 35 prevalent patients who were investigated 6, 12, and 24 months after their switch from HD to ol-HDF. Most patients had increased levels of the calcification inhibitors OPN and OPG; and of the inactive calcification inhibitor dp-ucMGP during the study period irrespective of the dialysis modality. BALP and t-ucMGP were mostly within the reference interval, but fetuin-A was mostly below the reference interval during the study period. OPN was significantly associated with BALP and parathyroid hormone, r = 0.62 and r = 0.65 (p amp;lt; .001), respectively. In conclusion, in contrast to decreased 25(OH)D levels, no differences were found for any of the measured biomarkers of VC following the switch from HD to ol-HDF. Further studies are needed to elucidate how these biomarkers can contribute to calcification risk assessment.

Place, publisher, year, edition, pages
Taylor & Francis, 2019. Vol. 79, no 3, p. 174-181
Keywords [en]
Alkaline phosphatase; chronic kidney disease; chronic renal insufficiency; renal dialysis; hemodiafiltration; osteopontin; pulse wave analysis; vascular calcification
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-157232DOI: 10.1080/00365513.2019.1576218ISI: 000465174400004PubMedID: 30775941Scopus ID: 2-s2.0-85064567552OAI: oai:DiVA.org:liu-157232DiVA, id: diva2:1324211
Note

Funding Agencies|ALF Grants Region Ostergotland; Linkoping University Hospital Research Fund (Region Ostergotland); Linkoping University Hospital Research Fund (Linkoping University); Signhild Engkvists Stiftelse in Stockholm, Sweden

Available from: 2019-06-13 Created: 2019-06-13 Last updated: 2019-06-18Bibliographically approved

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Uhlin, FredrikFernström, Anders

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Uhlin, FredrikFernström, AndersMagnusson, Per
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Division of Drug ResearchFaculty of Medicine and Health SciencesDepartment of NephrologyDivision of Clinical ChemistryDepartment of Clinical Chemistry
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Scandinavian Journal of Clinical and Laboratory Investigation
Gastroenterology and Hepatology

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