Skip to main content
Article
Bone Markers Predict Cardiovascular Events in Chronic Kidney Disease
Journal of Bone and Mineral Research (2008)
  • Astrid Fahrleitner-Pammer, Medical University, Australia
  • Johann Herberth, University of Kentucky
  • Steven R. Browning, University of Kentucky
  • Barbara Obermayer-Pietsch, Medical University, Australia
  • Gerhard Wirnsberger, Medical University, Australia
  • Herwig Holzer, Medical University, Australia
  • Harald Dobnig, Medical University, Australia
  • Hartmut H. Malluche, University of Kentucky
Abstract
Recent studies have indicated a link between bone metabolism and cardiovascular events in patients with chronic kidney disease (CKD). CKD is a major health problem worldwide. This study evaluates the role of noninvasive markers of bone metabolism in predicting cardiovascular morbidity (coronary artery disease, peripheral vascular disease, stroke) and mortality in patients with mild to severe forms of CKD. In a prospective cohort study, 627 patients with CKD were screened. To focus on bone metabolism, traditional risk factors for cardiovascular events were excluded, and 135 patients with CKD stages 1–5 were followed for 4 yr. Glomerular filtration rate was calculated by the Modification of Diet in Renal Disease formula. PTH (measured by four different assays), vitamin D 25 and 1,25, bone-specific alkaline phosphatase (BSALP), TRACP-5b, osteocalcin, serum collagen cross-link molecules, RANKL, and osteoprotegerin were determined. Predictors of cardiovascular events were evaluated by multivariable logistic regression, Kaplan-Meier survival, and Cox regression analysis. There were a total of 45 cardiovascular events (33%). Event rates were 5.6%, 29.1%, 45.2%, and 45.0% in CKD stages 1–2, 3, 4, and 5, respectively. In logistic regression, cardiovascular events were predicted only by (1) CKD stage (independent of age or sex; p < 0.001); (2) BSALP (p = 0.03); and (3) TRACP-5b (p = 0.04). Markers of bone formation (BSALP) and resorption (TRACP-5b) can serve as predictors of cardiovascular morbidity and mortality in CKD.
Keywords
  • Chronic kidney disease,
  • CKD,
  • Cardiovascular mortality,
  • PTH,
  • TRACP
Publication Date
November, 2008
DOI
https://doi.org/10.1359/jbmr.080610
Citation Information
Astrid Fahrleitner-Pammer, Johann Herberth, Steven R. Browning, Barbara Obermayer-Pietsch, et al.. "Bone Markers Predict Cardiovascular Events in Chronic Kidney Disease" Journal of Bone and Mineral Research Vol. 23 Iss. 11 (2008) p. 1850 - 1858
Available at: http://works.bepress.com/steven_browning/10/