Factors associated with serum fetuin-A concentrations after long-term use of different phosphate binders in hemodialysis patients

BMC Nephrology

Research Article

Ming-Shiou Wu¹  Hung-Hsiang Liou²  Hsin-Hung Lin³  Chiu-Ching Huang³ 

[1] Division of Nephrology, National Taiwan University Hospital, Taipei, Taiwan;Hsin-Jen Hospital, Taipei, Taiwan;The Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung, Taiwan;Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan;

关键词: Phosphate binder;    Sevelamer;    Fetuin-A;    Hemodialysis;    CKD;    ESRD;   

DOI  :  10.1186/s12882-016-0245-3

 received in 2015-05-30, accepted in 2016-03-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundFetuin-A is known as a circulating inhibitor of vascular calcification. Factors associated with serum fetuin-A concentrations after long-term use of different phosphate binders in hemodialysis patients is still uncertain.MethodsIn the post-hoc study, we analyzed serum fetuin-A and biochemical factors (Ca, P, i-PTH, hsCRP, TG, LDL-C) in 50 hemodialysis patients, who completed a 48-week, open-Label, controlled randomized parallel-group study. 23 patients received sevelamer and 27 patients received calcium carbonate.ResultsAfter the 48-week treatment, the sevelamer group had less serum calcium increment, less iPTH decrement, more ALK-P increment, more hsCRP decrement and more LDL-C decrement. There was no significant difference in the serum fetuin-A decrement between two groups. Decreased serum fetuin-A levels were found after 48-week treatment in both groups: from 210.61 (104.73) to 153.85 (38.64) ug/dl, P = 0.003 in sevelamer group, from 203.95 (107.87) to 170.90 (58.02) ug/mL, P =0.002 in calcium group. The decrement in serum fetuin-A (Δfetuin-A) levels was associated with ΔCa (ρ = - 0.230, P = 0.040), ΔiPTH (ρ = 0.306, P = 0.031) and Δalbumin (ρ = 0.408, P = 0.003), not associated with sevelamer use, ΔP and ΔhsCRP.ConclusionAfter long-term sevelamer or calcium carbonate treatment, both groups of maintenance HD patients had lower serum fetuin-A levels. Serum levels of increased calcium, decreased iPTH and decreased albumin were associated with the serum fetuin-A decrement.

【 授权许可】

CC BY   
© Lin et al. 2016