Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 4, April, p. 499–505

doi: 10.17219/acem/82517

Publication type: original article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

The importance of fetuin-A in vascular calcification in children with chronic kidney disease

Irena Makulska1,A,B,C,D, Maria Szczepańska2,B,D, Dorota Drożdż3,B, Dorota Polak-Jonkisz1,B, Danuta Zwolińska1,A,C,D,E,F

1 Department of Pediatric Nephrology, Faculty of Medicine, Wroclaw Medical University, Poland

2 Department of Pediatrics in Zabrze, Medical University of Silesia, Katowice, Poland

3 Dialysis Unit, Jagiellonian University Medical College, Kraków, Poland

Abstract

Background. The status of the cardiovascular (CV) system in children with chronic kidney disease (CKD) is significantly influenced by increasing stiffness of the arterial wall. This largely depends on the shortage of local and systemic inhibitors of soft tissue calcification.
Objectives. The aim of the study was to evaluate the role of fetuin-A in conjunction with other factors in the progressive hardening of the vascular wall in these children. We examined serum fetuin-A concentrations in relation to renal function, dialysis modality, and other clinical and biochemical markers promoting vascular calcification.
Material and Methods. Twenty children on peritoneal dialysis (PD), 20 on hemodialysis (HD), 36 treated conservatively, and 26 healthy subjects were enrolled into a cross-sectional study. In all children, fetuin-A and numerous clinical and biochemical parameters were measured.
Results. The fetuin-A concentration was significantly lower in children on hemodialysis (HD) vs children on peritoneal dialysis (PD), conservatively treated subjects, and the control group. In sick children, fetuinA concentration negatively correlated with dialysis vintage, PWV/ht, phosphate concentration, calcium phosphate product (CaxP), cumulative doses of calcium, and vitamin D3. In the whole study population, fetuin-A negatively correlated with blood pressure (BP), pulse wave velocity indexed to height (PWV/ht), intact parathyroid hormone (iPTH), high sensitivity C-reactive protein (hsCRP), and cholesterol concentrations.
Conclusion. In children with CKD, the decreased concentration of fetuin-A is related to other vascular calcification risk factors. Serum fetuin-A concentration may play a role in the identification of vascular disease risk factors in this population.

Key words

children, chronic kidney disease, fetuin-A

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