Serum sclerostin: relation with mortality and impact of hemodiafiltration

Lotte Lips, Camiel L M de Roij van Zuijdewijn, Piet M Ter Wee, Michiel L Bots, Peter J Blankestijn, Marinus A van den Dorpel, Denis Fouque, Renate de Jongh, Solenne Pelletier, Marc G Vervloet, Menso J Nubé, Muriel P C Grooteman

Research output: Contribution to journalArticleProfessional

Abstract

BACKGROUND: The glycoprotein sclerostin (Scl; 22 kDa), which is involved in bone metabolism, may play a role in vascular calcification in haemodialysis (HD) patients. In the present study, we investigated the relation between serum Scl (sScl) and mortality. The effects of dialysis modality and the magnitude of the convection volume in haemodiafiltration (HDF) on sScl were also investigated.

METHODS: In a subset of patients from the CONTRAST study, a randomized controlled trial comparing HDF with HD, sScl was measured at baseline and at intervals of 6, 12, 24 and 36 months. Patients were divided into quartiles, according to their baseline sScl. The relation between time-varying sScl and mortality with a 4-year follow-up period was investigated using crude and adjusted Cox regression models. Linear mixed models were used for longitudinal measurements of sScl.

RESULTS: The mean (±standard deviation) age of 396 test subjects was 63.6 (±13.9 years), 61.6% were male and the median follow-up was 2.9 years. Subjects with the highest sScl had a lower mortality risk than those with the lowest concentrations [adjusted hazard ratio 0.51 (95% confidence interval, CI, 0.31-0.86, P = 0.01)]. Stratified models showed a stable sScl in patients treated with HD (Δ +2.9 pmol/L/year, 95% CI -0.5 to +6.3, P = 0.09) and a decreasing concentration in those treated with HDF (Δ -4.5 pmol/L/year, 95% CI -8.0 to -0.9, P = 0.02). The relative change in the latter group was related to the magnitude of the convection volume.

CONCLUSIONS: (i) A high sScl is associated with a lower mortality risk in patients with end-stage kidney disease; (ii) treatment with HDF causes sScl to fall; and (iii) the relative decline in patients treated with HDF is dependent on the magnitude of the convection volume.

Original languageEnglish
Article numbergfw246
JournalNephrology, Dialysis, Transplantation
DOIs
Publication statusPublished - 23 Jun 2016

Cite this

@article{c5ae62be44bc427999577f8bd33db961,
title = "Serum sclerostin: relation with mortality and impact of hemodiafiltration",
abstract = "BACKGROUND: The glycoprotein sclerostin (Scl; 22 kDa), which is involved in bone metabolism, may play a role in vascular calcification in haemodialysis (HD) patients. In the present study, we investigated the relation between serum Scl (sScl) and mortality. The effects of dialysis modality and the magnitude of the convection volume in haemodiafiltration (HDF) on sScl were also investigated.METHODS: In a subset of patients from the CONTRAST study, a randomized controlled trial comparing HDF with HD, sScl was measured at baseline and at intervals of 6, 12, 24 and 36 months. Patients were divided into quartiles, according to their baseline sScl. The relation between time-varying sScl and mortality with a 4-year follow-up period was investigated using crude and adjusted Cox regression models. Linear mixed models were used for longitudinal measurements of sScl.RESULTS: The mean (±standard deviation) age of 396 test subjects was 63.6 (±13.9 years), 61.6{\%} were male and the median follow-up was 2.9 years. Subjects with the highest sScl had a lower mortality risk than those with the lowest concentrations [adjusted hazard ratio 0.51 (95{\%} confidence interval, CI, 0.31-0.86, P = 0.01)]. Stratified models showed a stable sScl in patients treated with HD (Δ +2.9 pmol/L/year, 95{\%} CI -0.5 to +6.3, P = 0.09) and a decreasing concentration in those treated with HDF (Δ -4.5 pmol/L/year, 95{\%} CI -8.0 to -0.9, P = 0.02). The relative change in the latter group was related to the magnitude of the convection volume.CONCLUSIONS: (i) A high sScl is associated with a lower mortality risk in patients with end-stage kidney disease; (ii) treatment with HDF causes sScl to fall; and (iii) the relative decline in patients treated with HDF is dependent on the magnitude of the convection volume.",
keywords = "Journal Article",
author = "Lotte Lips and {de Roij van Zuijdewijn}, {Camiel L M} and {Ter Wee}, {Piet M} and Bots, {Michiel L} and Blankestijn, {Peter J} and {van den Dorpel}, {Marinus A} and Denis Fouque and {de Jongh}, Renate and Solenne Pelletier and Vervloet, {Marc G} and Nub{\'e}, {Menso J} and Grooteman, {Muriel P C}",
note = "{\circledC} The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.",
year = "2016",
month = "6",
day = "23",
doi = "10.1093/ndt/gfw246",
language = "English",
journal = "Nephrology, Dialysis, Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",

}

Serum sclerostin : relation with mortality and impact of hemodiafiltration. / Lips, Lotte; de Roij van Zuijdewijn, Camiel L M; Ter Wee, Piet M; Bots, Michiel L; Blankestijn, Peter J; van den Dorpel, Marinus A; Fouque, Denis; de Jongh, Renate; Pelletier, Solenne; Vervloet, Marc G; Nubé, Menso J; Grooteman, Muriel P C.

In: Nephrology, Dialysis, Transplantation, 23.06.2016.

Research output: Contribution to journalArticleProfessional

TY - JOUR

T1 - Serum sclerostin

T2 - relation with mortality and impact of hemodiafiltration

AU - Lips, Lotte

AU - de Roij van Zuijdewijn, Camiel L M

AU - Ter Wee, Piet M

AU - Bots, Michiel L

AU - Blankestijn, Peter J

AU - van den Dorpel, Marinus A

AU - Fouque, Denis

AU - de Jongh, Renate

AU - Pelletier, Solenne

AU - Vervloet, Marc G

AU - Nubé, Menso J

AU - Grooteman, Muriel P C

N1 - © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

PY - 2016/6/23

Y1 - 2016/6/23

N2 - BACKGROUND: The glycoprotein sclerostin (Scl; 22 kDa), which is involved in bone metabolism, may play a role in vascular calcification in haemodialysis (HD) patients. In the present study, we investigated the relation between serum Scl (sScl) and mortality. The effects of dialysis modality and the magnitude of the convection volume in haemodiafiltration (HDF) on sScl were also investigated.METHODS: In a subset of patients from the CONTRAST study, a randomized controlled trial comparing HDF with HD, sScl was measured at baseline and at intervals of 6, 12, 24 and 36 months. Patients were divided into quartiles, according to their baseline sScl. The relation between time-varying sScl and mortality with a 4-year follow-up period was investigated using crude and adjusted Cox regression models. Linear mixed models were used for longitudinal measurements of sScl.RESULTS: The mean (±standard deviation) age of 396 test subjects was 63.6 (±13.9 years), 61.6% were male and the median follow-up was 2.9 years. Subjects with the highest sScl had a lower mortality risk than those with the lowest concentrations [adjusted hazard ratio 0.51 (95% confidence interval, CI, 0.31-0.86, P = 0.01)]. Stratified models showed a stable sScl in patients treated with HD (Δ +2.9 pmol/L/year, 95% CI -0.5 to +6.3, P = 0.09) and a decreasing concentration in those treated with HDF (Δ -4.5 pmol/L/year, 95% CI -8.0 to -0.9, P = 0.02). The relative change in the latter group was related to the magnitude of the convection volume.CONCLUSIONS: (i) A high sScl is associated with a lower mortality risk in patients with end-stage kidney disease; (ii) treatment with HDF causes sScl to fall; and (iii) the relative decline in patients treated with HDF is dependent on the magnitude of the convection volume.

AB - BACKGROUND: The glycoprotein sclerostin (Scl; 22 kDa), which is involved in bone metabolism, may play a role in vascular calcification in haemodialysis (HD) patients. In the present study, we investigated the relation between serum Scl (sScl) and mortality. The effects of dialysis modality and the magnitude of the convection volume in haemodiafiltration (HDF) on sScl were also investigated.METHODS: In a subset of patients from the CONTRAST study, a randomized controlled trial comparing HDF with HD, sScl was measured at baseline and at intervals of 6, 12, 24 and 36 months. Patients were divided into quartiles, according to their baseline sScl. The relation between time-varying sScl and mortality with a 4-year follow-up period was investigated using crude and adjusted Cox regression models. Linear mixed models were used for longitudinal measurements of sScl.RESULTS: The mean (±standard deviation) age of 396 test subjects was 63.6 (±13.9 years), 61.6% were male and the median follow-up was 2.9 years. Subjects with the highest sScl had a lower mortality risk than those with the lowest concentrations [adjusted hazard ratio 0.51 (95% confidence interval, CI, 0.31-0.86, P = 0.01)]. Stratified models showed a stable sScl in patients treated with HD (Δ +2.9 pmol/L/year, 95% CI -0.5 to +6.3, P = 0.09) and a decreasing concentration in those treated with HDF (Δ -4.5 pmol/L/year, 95% CI -8.0 to -0.9, P = 0.02). The relative change in the latter group was related to the magnitude of the convection volume.CONCLUSIONS: (i) A high sScl is associated with a lower mortality risk in patients with end-stage kidney disease; (ii) treatment with HDF causes sScl to fall; and (iii) the relative decline in patients treated with HDF is dependent on the magnitude of the convection volume.

KW - Journal Article

U2 - 10.1093/ndt/gfw246

DO - 10.1093/ndt/gfw246

M3 - Article

JO - Nephrology, Dialysis, Transplantation

JF - Nephrology, Dialysis, Transplantation

SN - 0931-0509

M1 - gfw246

ER -