Fetuin-A and kidney function in persons with coronary artery disease--data from the Heart and Soul Study.

Full Abstract

BACKGROUND:
Fetuin-A is a serum protein that inhibits ectopic vascular calcification and is present in lower concentrations in end-stage renal disease than in healthy controls. Whether fetuin-A concentrations are also lower in the setting of mild-to-moderate chronic kidney disease (CKD) is unknown.

METHODS:
We evaluated the associations of several parameters of kidney function including measured 24 h urinary creatinine clearance (CrCl), estimated glomerular filtration rate (GFR) by the Mayo Clinic quadratic GFR equation (qGFR), serum cystatin-C concentrations, and urinary albumin-to-creatinine ratio with serum fetuin-A concentrations in 970 outpatients with coronary artery disease. We used general linear models to determine the adjusted mean fetuin-A concentrations within each kidney function category.

RESULTS:
The mean age of the study sample was 67 years, 82% were male, 71% had hypertension and 26% had diabetes mellitus. In adjusted analysis, we observed no significant differences in mean fetuin-A concentrations across groups defined by CrCl, qGFR, or albumin-to-creatinine ratio groups. For example, adjusted mean fetuin-A concentrations were 0.66 g/l in participants with CrCl > 90, 60-90 and 45-60 ml/min/1.73 m(2), and 0.65 g/l in participants with CrCl < 45 ml/min/1.73 m(2). Higher serum cystatin-C (indicating worse kidney function) was associated with higher adjusted mean serum fetuin-A concentrations (lowest quartile 0.62 g/l, highest quartile 0.68 g/l; P for trend <0.001).

CONCLUSIONS:
Among ambulatory patients with coronary artery disease, there is no evidence that mild-to-moderate CKD is associated with lower concentrations of serum fetuin-A compared with persons with normal renal function. The mechanisms explaining the association between CKD and vascular calcification remain elusive.

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Author information

Author/s: Ix, Joachim H (JH); Chertow, Glenn M (GM); Shlipak, Michael G (MG); Brandenburg, Vincent M (VM); Ketteler, Markus (M); Whooley, Mary A (MA);

Affiliation: Division of Nephrology, Department of Medicine, Box 0532, HSE 672, University of California, San Francisco, San Francisco, CA 94143-0532, USA. jix(-atsign-)medicine.ucsf.edu

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.

Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant), published in England. (Language: eng)

Reference: 2006-Aug; vol 21 (issue 8) : pp 2144-51

Dates: Created 2006/07/26; Completed 2007/04/04; Revised 2008/11/21;

PMID: 16644775, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Albuminuria - etiology
Biological Markers
Blood Proteins - analysis; deficiency
Calcium - blood
Chronic Disease
Cohort Studies
Comorbidity
Coronary Disease - blood; complications; epidemiology; physiopathology
Creatinine - urine
Cystatin C
Cystatins - blood
Diabetes Complications - blood; physiopathology
Female

Female
Glomerular Filtration Rate
Humans
Hypercholesterolemia - epidemiology
Hypertension - blood; epidemiology; physiopathology
Kidney - physiopathology
Kidney Diseases - blood; complications; epidemiology; physiopathology
Male
Metabolic Clearance Rate
Middle Aged
Obesity - epidemiology
Phosphorus - blood
Prospective Studies
San Francisco - epidemiology

Associated Chemicals: Biological Markers (0) ; Blood Proteins (0) ; CST3 protein, human (0) ; Cystatin C (0) ; Cystatins (0) ; alpha2HS glycoprotein (0) ; Creatinine (60-27-5) ; Calcium (7440-70-2) ; Phosphorus (7723-14-0)

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