Does the OPG/RANKL system contribute to the bone-vascular axis in chronic kidney disease? A systematic review

Znorko, Beata; Oksztulska-Kolanek, Ewa; Michałowska, Małgorzata; Kamiński, Tomasz W.; Pawlak, Krystyna

doi:10.1016/j.advms.2016.08.001

Cited by 17 publications

(16 citation statements)

References 134 publications

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“…© 2018 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy Ther Apher Dial, Vol. 22, No 5,. 2018 Elevated OPG Levels in HD Patients With Artery Calcification…”

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confidence: 99%

“…Osteoprotegerin and RANKL play essential roles in the regulation of bone metabolism and may be regarded as a possible link between vascular calcification (VC) and bone and mineral metabolism in chronic kidney disease (CKD) patients . It is believed that elevated OPG levels are associated with the progression of vascular atherosclerosis and calcification in patients on hemodialysis (HD), growth of abdominal aortic aneurysms, development and progression of atrial fibrillation, the presence and severity of coronary artery disease (CAD) and cardiovascular (CV) risk in the general population .…”

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confidence: 99%

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Elevated Circulating Osteoprotegerin Levels in the Plasma of Hemodialyzed Patients With Severe Artery Calcification

et al. 2018

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We studied the correlations between circulating osteoprotegerin (OPG) level and radial artery calcification (RAC) assessed histologically and carotid artery intima-media thickness (CCA-IMT). Moreover, we studied the relationship between OPG levels and all-cause and cardiovascular (CV) mortality during a 5-year observation period. The study comprised 59 CKD patients (36 hemodialyzed (HD), 23 predialysis). The biochemical parameters included: creatinine, calcium, phosphate, intact parathormone, C-reactive protein, interleukin-6, tumor necrosis factor receptor II (TNFRII), transforming growth factor-β, hepatocyte growth factor, fibroblast growth factor 23, osteonectin (ON), osteopontin, osteoprotegerin, and osteocalcin. CCA-IMT and the presence of atherosclerotic plaques was assessed by ultrasound. Fragments of radial artery obtained during creation of HD access were prepared for microscopy and stained for calcifications with alizarin red. RAC was detected in 34 patients (58%). In multiple regression adjusted for dialysis status, TNFRII, ON and Framingham risk score (FRS) were identified as the independent predictors of OPG. Serum OPG above the median value of 7.55 pmol/L significantly predicted the presence of RAC in simple logistic regression (OR 5.33; 95%CI 1.39-20.4; P = 0.012) and in multiple logistic regression adjusted for FRS, dialysis status and CCA-IMT values (OR 6.56; 95%CI 1.06-40.6; P = 0.036). OPG levels above the median were associated with higher CCA-IMT values (1.02 ± 0.10 vs. 0.86 ± 0.13; P < 0.001) and predicted the presence of atherosclerotic plaques in carotid artery (OR 14.4; 95%CI 2.84-72.9; P < 0.001), independently of FRS, dialysis status and RAC. In this study, elevated serum OPG levels correlated with higher CCA-IMT, the presence of atherosclerotic plaques and the severity of the RAC independently of each other. During follow-up, 25 patients (42%) died, including 21 due to CV causes. In multiple Cox regression, OPG above the median predicted overall survival independently of dialysis status, Framingham risk score, CCA-IMT above the median value, and the presence of atherosclerotic plaques in CCA, but not independently of RAC. We postulate that circulating OPG may play a dual role as a marker for both medial arterial calcification and atherosclerosis, hence it seems to be a valuable tool for assessing CV risk in patients with CKD. OPG might be an early indicator of all-cause mortality in CKD patients with advanced medial arterial calcification.

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Elevated Circulating Osteoprotegerin Levels in the Plasma of Hemodialyzed Patients With Severe Artery Calcification

et al. 2018

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“…Studije pokazuju kako bi kombinacija PTH-a s biokemijskim biljezima koji odražavaju osteoblastičnu i osteoklastičnu aktivnost povećala osjetljivost i specifičnost u dijagnostici i praćenju smanjene, normalne i pojačane koštane pregradnje. Protekle godine donijele su otkriće novih članova superobitelji receptora čimbenika tumorske nekroze (TNF receptora) -OPG/RANK/RANKL sustav kao regulatora pregradnje kostiju 14,15 . U koštanom tkivu osteoprotegerin (OPG) proizvode osteoblasti koji djeluje kao "lažni'' receptor te blokira povezivanje između receptora aktivatora nuklearnog čimbenika kB (RANK) i njegovog liganda (RANKL) 16,17 .…”

Section: Serum Expression Of Opg/rankl System In Chronic Kidney Diseaunclassified

“…Na ovaj način dolazi do smanjenja broja aktivnih osteoklasta te se povećava volumen i mineralna gustoća kostiju. RANKL je eksprimiran na osteoblastima kao transmembranski protein, ali se također može naći i u cirkulaciji u topljivom obliku 15,18 . Njegovo djelovanje stimulira diferencijaciju i aktivaciju osteoklasta.…”

Section: Serum Expression Of Opg/rankl System In Chronic Kidney Diseaunclassified

Serumska ekspresija OPG/RANKL sustava u kroničnoj bubrežnoj bolesti i kod primatelja bubrežnog transplantata

Lončarić

Ćelić

2020

Med. Flum. (Online)

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Cilj: Ciljevi ove studije su istražiti ima li omjer serumskih vrijednosti RANKL/OPG bolje prognostičke vrijednosti uspoređen s razinom iPTH-a u serumu te ispitati ovise li razine OPG-a i RANKL-a u serumu o terapiji vitaminom D. Ispitanici i metode: Istraživanje je obuhvatilo 120 pacijenata iz Kliničkog bolničkog centra Rijeka, Hrvatska. Pacijenti su podijeljeni u dvije skupine; skupina pacijenata na hemodijalizi (HD) i skupina primatelja bubrežnog transplantata. Primatelji transplantata bubrega uključeni su u trenutku transplantacije te praćeni 12 mjeseci nakon transplantacije. Rezultati: Prema rezultatima ovog istraživanja, serumske razine RANKL/OPG u skupini pacijenata na hemodijalizi koji su imali iPTH > 33 pmol/l i iPTH < 11 pmol/l bile su značajno veće u odnosu na one koji su imali iPTH 11 – 33 pmol/l. Također, razine RANKL/OPG u skupini primatelja bubrežnog transplantata koji su imali iPTH > 33 pmol/l i iPTH < 11 pmol/l bile su značajno veće, u usporedbi s onima koji su imali iPTH 11 – 33 pmol/l. Pacijenti na hemodijalizi i primatelji bubrežnog transplantata na terapiji vitaminom D imali su značajno više razine OPG-a u serumu i značajno nižu razinu sRANKL-a, od ispitanika bez terapije vitaminom D. Zaključak: Rezultati ovog istraživanja ukazuju na povoljan učinak vitamina D u prevenciji gubitka koštane mase kod pacijenata na hemodijalizi i kod primatelja bubrežnog transplantata. Omjer serumske razine RANKL/OPG korelira s vrijednostima iPTH-a, ali ostaje nejasno zašto je omjer RANKL/OPG nizak u umjereno povišenim vrijednostima iPTH-a te su potrebna dodatna istraživanja kako bismo dobili odgovor na ovo pitanje.

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“…There is no consensus about the relationship between OPG and cardiovascular morbidity and mortality in HD patients, still raising questions regarding its role 3,6 .…”

Section: Introductionmentioning

confidence: 99%

Arterial Calcifications and Osteoprotegerin in Chronic Hemodialysis Patients – Impact on 6 Years Survival

Moldovan

Rusu

Potra

et al. 2021

Preprint

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The study goal was to assess the impact of each type of arterial intimal calcifications (AIC) and arterial medial calcifications (AMC) identified on ultrasound, of osteoprotegerin (OPG), mineral metabolism markers and other features on all-cause and cardiovascular mortality in chronic hemodialysis patients. Ultrasound was performed in 87 patients on the carotid and femoral arteries, and the severity of AIC and AMC was assessed calculating a score according to the extension of calcification. The cut-off value for OPG determined using ROC was 4.9 pmol/L for all-cause and cardiovascular mortality. Patients with higher serum OPG levels presented higher mortality rates. Our results revealed that AIC, high OPG, low ankle-arm index, presence of diabetes, smoking status, and lack of arteriovenous fistula are associated with all-cause and cardiovascular mortality in univariate regression analysis. Multivariate analysis identified AIC scoring based on the segmentation method as an independent predictor of all-cause and cardiovascular mortality, along with increased OPG levels. AMC scoring was not a predictor of mortality. Identifying and scoring AIC on ultrasound and measuring OPG levels, as a basis of the HD patient assessment may become valuable tools in clinical work, as these have an impact on death toll.

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Does the OPG/RANKL system contribute to the bone-vascular axis in chronic kidney disease? A systematic review

Cited by 17 publications

References 134 publications

Elevated Circulating Osteoprotegerin Levels in the Plasma of Hemodialyzed Patients With Severe Artery Calcification

Elevated Circulating Osteoprotegerin Levels in the Plasma of Hemodialyzed Patients With Severe Artery Calcification

Serumska ekspresija OPG/RANKL sustava u kroničnoj bubrežnoj bolesti i kod primatelja bubrežnog transplantata

Arterial Calcifications and Osteoprotegerin in Chronic Hemodialysis Patients – Impact on 6 Years Survival

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