Uremic toxicity and sclerostin in chronic kidney disease patients

Desjardins, Lucie; Liabeuf, Sophie; Oliveira, Rodriguo B; Louvet, Loı̈c; Kamel, Saı̈d; Lemke, Horst‐Dieter; Vanholder, Raymond; Choukroun, Gabriel; Massy, Ziad A.

doi:10.1016/j.nephro.2014.04.002

Cited by 75 publications

(81 citation statements)

References 45 publications

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“…The significantly higher sclerostin levels we observed in the patient group compared to the controls was in concordance with previously published results [26, 28, 30-32]. The cause for the observed high level may be higher sclerostin production by osteocytes rather than retention due to compromised renal function, since it has been shown that urinary secretion of sclerostin increases with declining eGFR [30, 33].…”

Section: Discussionsupporting

confidence: 92%

Is Sclerostin Level Associated with Cardiovascular Diseases in Hemodialysis Patients?

et al. 2018

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Background/Aims: The objective of this study is to evaluate the relation between sclerostin, arterial stiffness, and cardiovascular events (CVE) in hemodialysis patients (HD). Methods: Sclerostin level and carotid-femoral pulse wave velocity (PWV) in 97 HD patients and sclerostin level in 40 controls were measured. Results: Sclerostin level was significantly higher in patients than in controls. Sclerostin associated positively with age, male gender, cardiovascular disease, statin use, BMI, and PWV while negatively with alkaline phosphatase, parathormone (PTH), Kt/V, cinacalcet and vitamin D use in univariable correlation analyses. Sclerostin associated positively with male gender and statin use but negatively with PTH in multivariate regression analyses. During observation, 30 fatal or nonfatal CVEs were observed. While univariate correlation analysis showed a positive association between PWV and sclerostin, there was no relation between the two in multivariate regression analysis. Conclusion: Further studies are needed to understand the role of sclerostin in predicting PWV changes in HD patients.

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Section: Discussionsupporting

confidence: 92%

Is Sclerostin Level Associated with Cardiovascular Diseases in Hemodialysis Patients?

et al. 2018

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“…In contrast, Desjardins et al [40] and Gonçalves et al [44] reported an inverse relationship between serum sclerostin levels and survival rate. This discrepancy remains poorly explained and could be the result of using different assays in both CKD and dialysis patients [36].…”

Section: Discussionmentioning

confidence: 96%

“…In HD patients, Brandenburg et al [20] reported an association between high serum sclerostin levels and aortic valvular calcification, but not coronary artery calcification. Desjardins et al [40] did not find any relationship between serum sclerostin levels and VC score (aortic valve and coronary arteries). Recently, Morena et al [21] reported, in non-dialysis CKD patients, that both high OPG and sclerostin levels are associated with VC.…”

Section: Discussionmentioning

confidence: 99%

High Serum Sclerostin Levels Are Associated with a Better Outcome in Haemodialysis Patients

Jean

Chazot

Bresson

et al. 2016

Nephron

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Background: Sclerostin is an osteocyte hormone that decreases osteoblastogenesis. Sclerostin may play a key role in osteoporosis and also in vascular calcification (VC). In chronic kidney disease and haemodialysis (HD) patients, serum sclerostin levels are high. Aim: To assess the correlation of serum sclerostin levels with VC, bone mineral density (BMD), and survival rate in HD patients. Methods: A cross-sectional study was conducted in prevalent HD patients to correlate serum sclerostin tertiles with the Kauppila aortic calcification score, BMD scores and survival rate. Results: We studied 207 patients who had a mean serum sclerostin level of 1.9 ± 0.7 ng/ml. Compared to patients in the 1st tertile of serum sclerostin levels (0.6-1.53 ng/ml), patients in the 3rd tertile (2.2-4.6 ng/ml) were significantly older (73.7 ± 12 vs. 64.7 ± 18 years), more frequently of the male gender (74 vs. 48%), had lower serum bone-specific alkaline phosphatases values (14 ± 9 vs. 20.4 ± 13 µg/l), were less frequently treated with alfacalcidol, displayed lower aortic calcification scores (9.5 ± 5 vs. 12.5 ± 7/24) and had higher BMD scores. Furthermore, patients of the 3rd tertile displayed a lower mortality rate compared to tertile 1 using multivariable adjusted Cox model (hazard ratio 0.5, 95% CI 0.25-0.93, p = 0.03). The main factors associated with VC score were age, diabetes, cardiovascular disease, CRP level and Warfarin use. Conclusion: Our study of HD patients shows that higher serum sclerostin levels are associated with higher BMD, lower aortic calcification scores, and a better survival rate.

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“…16,17 Consequently, further analyses are necessary in order to better establish the prognostic role of sclerostin in dialyzed patients, evaluating the potential effects of its elimination through specific filters and dialysis techniques. Its reduction obtained through AFB could represent a defensive mechanism, blocking or attenuating the canonical Wnt pathway, improving vascular disease and renal osteodystrophy.…”

mentioning

confidence: 99%

Sclerostin levels in uremic patients: a link between bone and vascular disease

et al. 2016

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Sclerostin is a marker of low-turnover bone disease in end stage renal disease patients. The aim of this study was to evaluate serum sclerostin in uremic patients, analyzing its behavior during a single hemodialysis session. Twenty-one adult patients on intermittent hemodialysis treatment were enrolled. Acetate Free Bio-filtration (AFB) was the technique employed. Uremic patients were characterized by higher levels of serum sclerostin when compared with values observed in healthy subjects. Sclerostin assessed in pre-dialysis samples was 1.4 6 1.02 ng/mL, whereas, in post dialysis samples, a reduction of sclerostin values was observed (0.8 6 0.6 ng/mL; p: 0.008). Sclerostin correlated with parameters of dialysis adequacy, such as creatinine levels and Kt/V values, and it was significantly associated with atherosclerotic disease. Receiver operating characteristics analysis revealed a good diagnostic profile in identifying atherosclerotic disease. Sclerostin, a full dialyzable substance during AFB dialysis, is closely associated with atherosclerotic disease. Its reduction obtained through AFB could represent a defensive mechanism, improving vascular disease and renal osteodystrophy. ARTICLE HISTORY

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Uremic toxicity and sclerostin in chronic kidney disease patients

Cited by 75 publications

References 45 publications

Is Sclerostin Level Associated with Cardiovascular Diseases in Hemodialysis Patients?

Is Sclerostin Level Associated with Cardiovascular Diseases in Hemodialysis Patients?

High Serum Sclerostin Levels Are Associated with a Better Outcome in Haemodialysis Patients

Sclerostin levels in uremic patients: a link between bone and vascular disease

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