Blood osteoprotegerin is associated with arteriovenous access thrombosis in hemodialysis patients.

IF 2.9 3区医学 Q1 UROLOGY & NEPHROLOGY Kidney Research and Clinical Practice Pub Date : 2024-10-25 DOI:10.23876/j.krcp.24.153

Tung-Ling Chung, Yi-Hsueh Liu, Pei-Yu Wu, Jiun-Chi Huang, Yi-Chun Tsai, Ya-Ling Hsu, Mei-Chuan Kuo, Yi-Wen Chiu, Ping-Hsun Wu, Szu-Chia Chen

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Abstract

Background: A functioning arteriovenous (AV) access is essential for hemodialysis efficiency and the quality of life in hemodialysis patients. Blood osteoprotegerin (OPG) and soluble receptor activator of nuclear factor kappa B ligand (RANKL) have been linked to cardiovascular diseases and vascular calcification. This study investigated the relationship between blood OPG, RANKL, and the occurrence of AV access thrombosis.

Methods: This prospective cohort study was conducted from August 2016 to August 2021 and included patients undergoing prevalent hemodialysis in two hospital-based hemodialysis units. Cox proportional hazards models and Kaplan-Meier analysis were used to evaluate the association between blood OPG, RANKL, and AV access (AV fistula [AVF] and AV graft [AVG]) outcomes.

Results: A total of 333 hemodialysis patients were enrolled, with an AV access thrombosis rate of 22.2%. Cox regression identified several factors associated with AV access thrombosis: AV access type (AVF vs. AVG; hazard ratio [HR], 0.24; p < 0.001), C-reactive protein (HR, 1.07; p = 0.002), and log-transformed OPG (HR, 5.52; p = 0.005). Subgroup analysis revealed high log-transformed OPG and RANKL were associated with AVF thrombosis (HR, 10.77; p = 0.002 and HR, 3.26; p = 0.009, respectively), while high C-reactive protein increased the risk of AVG thrombosis (HR, 1.31; p < 0.001). Kaplan-Meier analysis showed that patients with AVF in the highest tertile of log OPG (>402 pg/mL) had the highest AVF thrombosis incidence (p = 0.03).

Conclusion: High blood OPG was associated with AV access thrombosis, particularly in the AVF.

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血液骨保护素与血液透析患者动静脉通路血栓形成有关。

背景：正常的动静脉（AV）通路对血液透析的效率和血液透析患者的生活质量至关重要。血液中的骨保护素（OPG）和可溶性核因子卡巴B配体受体激活剂（RANKL）与心血管疾病和血管钙化有关。本研究探讨了血液中 OPG、RANKL 与动静脉通路血栓形成之间的关系：这项前瞻性队列研究于2016年8月至2021年8月进行，纳入了在两家医院血液透析室进行流行性血液透析的患者。采用Cox比例危险模型和Kaplan-Meier分析评估血液中OPG、RANKL和AV通路（AV瘘[AVF]和AV移植[AVG]）结果之间的关联：共有 333 名血液透析患者入选，其中动静脉通路血栓形成率为 22.2%。Cox回归确定了与动静脉通路血栓形成相关的几个因素：动静脉通路类型（AVF 与 AVG；危险比 [HR]，0.24；p < 0.001）、C 反应蛋白（HR，1.07；p = 0.002）和经对数转换的 OPG（HR，5.52；p = 0.005）。亚组分析显示，高对数转换 OPG 和 RANKL 与动静脉瘘血栓形成有关（HR，10.77；p = 0.002 和 HR，3.26；p = 0.009），而高 C 反应蛋白会增加动静脉瘘血栓形成的风险（HR，1.31；p < 0.001）。Kaplan-Meier分析显示，OPG对数最高三分位数（>402 pg/mL）的动静脉瘘患者的动静脉瘘血栓形成发生率最高（p = 0.03）：结论：高血 OPG 与动静脉通路血栓形成有关，尤其是在动静脉瘘中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney Research and Clinical Practice UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

10.00%

发文量

审稿时长

10 weeks

期刊介绍： Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.