Serum osteoprotegerin is a predictor of progression of atherosclerosis and coronary calcification in hemodialysis patients

Nephron Clin Pract. 2011;117(4):c297-304. doi: 10.1159/000321169. Epub 2010 Sep 22.


Background: The aim of this prospective cohort study was to evaluate the progression of coronary artery calcification (CAC), and atherosclerosis in hemodialysis (HD) patients and to relate them to novel biomarkers, i.e. serum osteoprotegerin (OPG) and fibroblast growth factor 23 (FGF-23).

Material and methods: Forty-seven HD patients were followed up for 30 months or until death. Intima media thickness (CCA-IMT), atherosclerotic plaques and CAC were assessed at baseline and after 30 months. Serum mineral parameters, lipids, OPG and plasma FGF-23 were also measured.

Results: At baseline, 70% HD patients presented detectable CAC. The patients without calcification at baseline remained calcification free at 30 months and presented lower serum OPG and FGF-23 than those with CAC. A 64.4% progression of CAC was observed in all patients with CAC at baseline. In parallel, a 13% increase in CCA-IMT was found. Both ΔCAC and ΔCCA-IMT correlated positively with baseline and follow-up serum OPG. The patients who died had significantly higher baseline CAC and serum OPG.

Conclusion: The plasma level of OPG could serve as a surrogate marker of progression of atherosclerosis and calcification in patients with end-stage renal disease. Therefore, the serum OPG may be a candidate biomarker of cardiovascular complications and poor outcome among dialysis patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Atherosclerosis / blood*
  • Atherosclerosis / diagnosis
  • Biomarkers / blood
  • Calcinosis / blood*
  • Calcinosis / diagnosis
  • Cohort Studies
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / diagnosis
  • Disease Progression
  • Female
  • Fibroblast Growth Factor-23
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Osteoprotegerin / blood*
  • Predictive Value of Tests
  • Prospective Studies
  • Renal Dialysis* / adverse effects


  • Biomarkers
  • FGF23 protein, human
  • Osteoprotegerin
  • Fibroblast Growth Factor-23