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Relationship between Arterial Calcification and Fetuin-A Levels in Patients with Chronic Kidney Disease at the Onset of Hemodialysis

Date: January 29,2023 |Hits: 294 Download PDF How to cite this paper

Felipe José de Moura Vianna1, André Falcão Pedrosa Costa2,*, Luciene Machado dos Reis3, Marcello Fabiano de Franco4, Fausto Miranda Junior5

1Masters in Science from Escola Paulista de Medicina, Vascular Surgeon at the Alagoas State General Hospital, Brazil.

2Professor at Federal University of Alagoas, Brazil.

3Research Biologist at LIM 16 University of São Paulo, Brazil.

4Professor-Retired- Affiliate professor in the Department of Pathology of Federal University of Sao Paulo, Brazil.

5Professor at Federal University of São Paulo, Brazil.

*Corresponding author: André Falcão Pedrosa Costa


Introduction: Arterial calcification is a negative predictor of morbidity and mortality in end-stage renal disease.  Traditional factors such as hypertension, dyslipidemia and non-traditional factors such as mineral disorders are involved in calcification.  They are generally classified as promoters and inhibitors.  Possible changes in inhibiting factors, such as fetuin-A, are responsible for the pathophysiology of vascular calcification.  Method: Arterial calcification was evaluated by withdrawing fragments of the artery to undergo the first arteriovenous fistula for hemodialysis.  Four histological stains were used to identify the presence of calcification while blood for fetuin determination was collected at the same time.  Demographic, clinical and laboratory data were analyzed to test possible relationships in the prevalence of vascular calcification.  Results: Thirty-four patients were enrolled and vascular calcification was detected in eight.  Statistical analysis revealed that calcification predictors were age and the presence of diabetes.  The correlation between arterial calcification and fetuin was 0.4 (r = of 0.033).  Conclusion: There is a tendency to an inverse correlation between arterial calcification and fetuin-A levels in patients with chronic kidney disease at the onset of hemodialysis.


[1] Goldsmith D, Ritz E, Covic A. Vascular calcification: a stiff challenge for the nephrologists. Does preventing bone disease cause arterial disease? Kidney Int. 2004; 66: 1315-33.

[2] Block G, Port FK. Calcium Phosphate metabolism and cardiovascular diseases in patients with chronic kidney disease. Semin Dial. 2003; 16(2):140-47. 

[3] Davies MR, Hruska KA. Pathophysiological mechanisms of vascular calcification in end-stage renal disease. Kidney interna-tional.2001; 60:472-9.

[4] Mehrotra R, Westenfeld R, Christenson P, Budoff M, Ipp E, Takasu J, Gupta A, Norris K, Ketteler M, Adler S. Serum fetuin-A in nondialyzed patients with diabetic nephropathy: Relationship with coronary artery calcification. Kidney International. 2005; 67:1070-77.

[5] Shanahan C M, Matthew H Crouthamel, Alexander Kapustin, Cecilia M Giachelli. Arterial calcification in chronic kidney disease: key roles for calcium and phosphate. Circulation research. 2011; 109:697-711.

[6] Smith E R, Cai M M, Mcmahon L P, Pedagogos E, Toussaint N, Brumby C, Holt S G. Serum fetuin-A concentration and fetuin-A-containing calciprotein particles in patients with chronic inflammatory disease and renal failure. Nephrology. 2013; 18: 215–21.

[7] Ketteler M, Gross ML, Ritz E. Calcification and cardiovascular problems in renal failure. Kidney International. 2005; 67: S120-27.

[8] Cozzolino M, GalassiA, Biondi ML, Turri O, Papagni S, Mongelli N, Civita L, Gallieni M, Brancaccio D. Serum fetuin- A levels link inflammation and cardiovascular calcification in hemodialysis patients. Am J Nephrol. 2006; 26:423-9.

[9] Hruska K A, Mathew S, Memon I, Saab G. The pathogenesis of vascular calcification in the chronic kidney disease mineral bone disorder. Semin Nephrol 2009; 29(2): 156–165.

[10] Histologia. JUNQUEIRA & JUNQUEIRA, 1983, pg21.

[11] Banff ’07 Meeting Report: Antibody Mediated Graft Deterioration and Implementation of Banff Working Groups American Journal of Transplantation 2008; 8: 753–60.

[12] Moe SM, O’Neill KD, Duan D, Ahmed S, Chen NX, Leapman SB, Fineberg N, Kopecky K. Medial artery calcification in ESRD patients is associated with deposition of bone matrix proteins. Kidney Int. 2002; 61(2): 638–47.

[13] Schlieper G, Aretz A, Verberckmoes S C, Krüger T, Behets GJ, Ghadimi R, Weirich TE, Rohrmann D, Langer S, Tordoir JH, Amann K, Westenfeld R, Brandenburg VM, D’Haese PC, Mayer J, Ketteler M, McKee MD, Floege J. Ultrastructural analysis of vascular calcifications in uremia. JASN. 2010; 21(4):689-96.

[14] Wang N, Yang J, Yu X, Hu J, Xing C, Ju X, Shen X, Qian J, Zhao X, Wang X. Radial artery calcification in end-stage renal disease patients is associated with deposition of osteopontin and diminished expression of a-smooth muscle actin. Nephology  2008; 13:367–75.

[15] Pencak P, Czerwieńska B, Ficek R, Wyskida K, Szewieczek A K, Glinianowicz MO, Wiecek A, Chudek J. Calcification of coronary arteries and abdominal aorta in relation to traditional and novel risk factors of atherosclerosis in hemodialysis patients. BMC Nephrology 2013, 14(10):1-9.

[16] Cozzolino M, Brenna I, Ciceri P, Volpi E, Cusi D, Brancaccio D. Vascular calcification in chronic kidney disease: a changing scenario. JNEPHROL. 2011; 24(S18):S03-10.

[17] Ford M L, Tomlinson L A, Smith E R, Rajkumar C, Holt SG. Fetuin-A is an independent determinant of change of aortic stiffness over 1 year in non-diabetic patients with CKD stages 3.

[18] Clark G. Staining Procedures. Williams and Wilkins, Baltimore MD. 1981. Pg187.

[19] Zheng S, Fuentes L, Bierhals A, Ash-Bernal R, Spence K, Slatopolsky E, Davila-Roman V G, and Delmez J. Relation of Serum Fetuin-A Levels to Coronary Artery Calcium in African-American Patients on Chronic Hemodialysis. Am J Cardiol. 2009 Jan 1; 103(1):46-9.

[20] Ossareh S , Rayatnia M, Vahedi M, Jafari H, Zebarjadi M. Association of Serum Fetuin-A with Vascular Calcification in He-modialysis Patients and Its' Impact on 3-year Mortality. Iran J Kidney Dis. 2020 Dec; 14(6):500-509.

[21] Rodrigues F G, Neves R F C A, Ormanji M S, Esper P L G, Gaspar M , Pereira R M R , Requião-Moura L R, de Borst M H Heilberg I P. Vascular Calcification Is Associated with Fetuin-A and Cortical Bone Porosity in Stone Formers. J Pers Med. 2022: 12(7):1120. 

[22] Makulska I, Szczepańska M, Drożdż D, Polak-Jonkisz D, Zwolińska D. The importance of fetuin-A in vascular calcification in children with chronic kidney disease. AdvClinExp Med. 2019 Apr; 28(4):499-505.

How to cite this paper

Relationship between Arterial Calcification and Fetuin-A Levels in Patients with Chronic Kidney Disease at the Onset of Hemodialysis

How to cite this paper: Felipe José de Moura Vianna, André Falcão Pedrosa Costa, Luciene Machado dos Reis, Marcello Fabiano de Franco, Fausto Miranda Junior. (2023) Relationship between Arterial Calcification and Fetuin-A Levels in Patients with Chronic Kidney Disease at the Onset of Hemodialysis. International Journal of Clinical and Experimental Medicine Research7(1), 11-16.

DOI: http://dx.doi.org/10.26855/ijcemr.2023.01.002

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