Fetuin-A is not associated with mortality in chronic kidney disease

• Published in: Kidney international Vol. 72; no. 11; pp. 1394 - 1399
• Main Authors: Ix, J.H., Shlipak, M.G., Sarnak, M.J., Beck, G.J., Greene, T., Wang, X., Kusek, J.W., Collins, A.J., Levey, A.S., Menon, V.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-12-2007; Nature Publishing; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; alpha-2-HS-Glycoprotein; Biological and medical sciences; Blood Proteins - metabolism; calcium; cardiovascular disease; Cardiovascular Diseases - metabolism; Cardiovascular Diseases - mortality; Chronic Disease; chronic kidney disease; Disease Progression; Female; Follow-Up Studies; Glomerular Filtration Rate - physiology; Humans; Kidney Diseases - blood; Kidney Diseases - mortality; Kidney Diseases - physiopathology; Kidneys; Male; Medical sciences; Middle Aged; mortality; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Predictive Value of Tests; Proportional Hazards Models; Renal failure; Severity of Illness Index; Urinary system involvement in other diseases. Miscellaneous; mortality; cardiovascular disease; chronic kidney disease; calcium; Kidney disease; Nephrology; Urinary system disease; Calcium; Mortality; Renal failure; Cardiovascular disease; Chronic kidney disease; Serum protein; Inorganic element; Epidemiology; Urology
• DOI: 10.1038/sj.ki.5002549
• EISSN: 1523-1755
• ISSN: 0085-2538

Fetuin-A is a serum protein that inhibits vascular calcification such that lower levels are associated with a higher prevalence of vascular calcification and mortality risk among end-stage renal disease populations. We analyzed data of 822 persons in the Modification of Diet in Renal Disease study, a randomized, controlled trial of persons with predominantly non-diabetic stage 3–4 chronic kidney disease (CKD). Serum fetuin-A levels were measured in baseline serum. Survival status and cause of death were determined by the National Death Index. Cox proportional hazard models evaluated the association of fetuin-A levels with all-cause and cardiovascular mortality. Glomerular filtration ranged from 13 to 55 ml per min per 1.73 m2. During a median follow-up of 9.5 years, 25% of persons died from any cause and 12% died from a cardiovascular cause. Compared to the lowest tertile, no association was found between the highest fetuin-A tertile and all-cause or cardiovascular mortality. Similarly, no association was found between fetuin-A as a continuous variable and all-cause or cardiovascular mortality. Our study shows that serum fetuin-A levels are not related to all-cause or cardiovascular mortality among persons with predominantly non-diabetic stage 3 or 4 CKD.