Evaluation of serum sclerostin level and its correlation with the cardiovascular outcome in patients with chronic kidney disease

Abstract

Background Cardiovascular calcification is a significant insult at all stages of chronic kidney disease (CKD). Vascular/valvular calcification was considered a strong predictor for cardiovascular morbidity and mortality in CKD population. Sclerostin is an inhibitor of the Wnt pathway that has an association with vascular calcification in various vascular beds. Aim To evaluate the serum sclerostin level and its correlation with the cardiovascular outcome in patients with CKD. Patients and methods The study group consisted of 70 patients (30 nondialysis patients with CKD and 40 hemodialysis patients with end-stage renal disease) and 20 healthy controls. The patients were followed up for 30 months for detection of cardiovascular events. Laboratory investigations including serum sclerostin level were calculated, and a standard two-dimensional transthoracic echocardiography was performed for detection of cardiac valve calcification. Results There was a significant increase in the serum sclerostin level in all patients with CKD when compared with the control group (P<0.001), There was a significant decrease in serum sclerostin level in patients with valvular calcification (P=0.016) when compared with patients with noncalcified valves. There was significant decrease in serum sclerostin in patients who developed cardiovascular morbidity (P<0.001), but no significant relation with cardiovascular mortality when compared with patients who did not develop CVD insults. Conclusion Decreased sclerostin level in patients with CKD is associated with increased incidence of valvular calcification, and also, there was a significant decline in serum sclerostin level in patients who developed cardiovascular morbidity, but there was no significant relation with cardiovascular mortality.