Osteopontin Levels in Patients With Chronic Kidney Disease Stage 5 on Hemodialysis Directly Correlate With Intact Parathyroid Hormone and Alkaline Phosphatase
Osteopontin Levels in Patients With Chronic Kidney Disease Stage 5 on Hemodialysis Directly Correlate With Intact Parathyroid Hormone and Alkaline Phosphatase
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DOI：
10.1177/1076029619896621
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发表时间：
2019-12-23
影响因子：
2.9
通讯作者：
Fareed, Jawed
中科院分区：
文献类型：
--
作者：
Druck, Aleksander;Patel, Dimpi;Fareed, Jawed
慢性肾脏病5期（CKD 5）标志着肾衰竭的第五阶段，经常导致骨和矿物质代谢失调。用标准生物标志物组评估和管理慢性肾脏病-矿物质骨疾病（CKD-MBD）存在挑战。我们的目的是分析CKD 5维持性血液透析（CKD 5-HD）患者的骨桥蛋白（OPN），并阐明其与磷（P）、钙（Ca 2+）、碱性磷酸酶（AP）和全段甲状旁腺激素（iPTH）的关系，以提高对目前CKD-MBD模型的理解。与正常组（n = 49;中位数：63.30 ng/mL，IQR：19.20 ng/mL; p < .0001）相比，在CKD 5-HD队列中观察到血浆OPN升高（n = 92;中位数：240.25 ng/mL，四分位数间距[IQR]：169.85 ng/mL）。斯皮尔曼相关性检验显示，在CKD 5-HD患者中，OPN与iPTH（p < .0001; r = 0.561，95%置信区间= 0.397-0.690）和OPN与AP（p < .0001; r = 0.444，95%置信区间= 0.245-0.590）显著正相关。最终，OPN可能在MBD轴中发挥不可或缺的作用，这表明在管理CKD 5-HD时积极监测OPN可能很重要。
Chronic kidney disease stage 5 (CKD5) marks the fifth stage of renal failure, frequently causing dysregulation of bone and mineral metabolism. Challenges exist in evaluating and managing chronic kidney disease-mineral bone disorder (CKD-MBD) with the standard panel of biomarkers. Our objective was to profile osteopontin (OPN) in patients with CKD5 on maintenance hemodialysis (CKD5-HD) and elucidate its relationship to phosphorus (P), calcium (Ca2+), alkaline phosphatase (AP), and intact parathyroid hormone (iPTH) to improve understanding of the present model of CKD-MBD. Elevation of plasma OPN was seen in the CKD5-HD cohort (n = 92; median: 240.25 ng/mL, interquartile range [IQR]: 169.85 ng/mL) compared to a normal group (n = 49; median: 63.30 ng/mL, IQR: 19.20 ng/mL; p < .0001). Spearman correlation tests revealed significant positive correlations of OPN with iPTH (p < .0001; r = 0.561, 95% confidence interval = 0.397-0.690) and OPN with AP (p < .0001; r = 0.444, 95% confidence interval = 0.245-0.590) in CKD5-HD patients. Ultimately, OPN may play an integral role in the MBD axis, suggesting that it may be important to actively monitor OPN when managing CKD5-HD.