Study of Plasma Osteoprotegerin level and arterial stiffness in chronic kidney disease and hemodialysis patients. - .

 Background: chronic kidney disease (CKD) is a serious illness which seriously affects body systems. The dramatically increased cardiovascular risk of death of uremic patients is directly associated with the magnitude of vascular calci?cation (VC). Disturbances in mineral and bone metabolism are common complications in CKD. They are an important cause of morbidity and decreased quality of life and, as with the development of renal bone disease, are major risk factors for VC. Arterial stiffness is a reduction in arterial dispensability. Increased central arterial stiffening is a hallmark of the aging process and the consequence of many disease states such as diabetes, atherosclerosis, and chronic renal compromised patients. In ESRD patients, the extent of arterial stiffness was a strong predictor of all-cause and CV mortality. Osteoprotegerin (OPG) is identical to osteoclastogenesis inhibitory factor (OCIF), a soluble member of the tumor-necrosis factor receptor family that inhibits osteoclastogenesis. OPG is considered to play an important role in the regulation of bone resorption by modifying osteoclast differentiation. Osteoprotegerin is an independent risk factor for the progression of vascular stiffness and onset of cardiovascular disease. Aim of the work: to assess plasma OPG levels and arterial stiffness in chronic kidney disease and hemodialysis (HD) patients. Patients and methods: 66 chronic Kidney disease and HD patients were examined for evidence of arterial stiffness. we excluded patients with liver disease, autoimmune disease, malignant disease and in?ammatory diseases, All patients subjected to full history taking: Through personal history taking with special stress on age, sex, hemodialysis duration, and presence of other systemic diseases especially cardiovascular diseases. Full clinical examination was done. Laboratory investigations: CBC, liver function tests, kidney function tests, calcium, phosphorus, parathyroid hormone and lipid pro?le. Speci?c investigations include plasma osteoprotegerin level. Radiological investigation: echocardiography and ultrasonography (Doppler on common carotid artery). Results: In chronic kidney patients, plasma levels of osteoprotegerin (OPG) were associated with pulse wave velocity (PWV) which is the mean marker of arterial stiffness, but not with common carotid intima-media thickness (ccIMT). Arterial stiffness was associated with history of cardiovascular disease (CVD), hypertension and diabetes mellitus. Arterial stiffness also showed a strong signi?cant positive correlation with OPG levels In hemodialysis patients, plasma OPG levels were associated with arterial stiffness and showed that OPG levels can, in part, explain the association between coronary artery calcification and CKD. Conclusion: high plasma OPG levels were associated with arterial stiffness and pulse wave velocity (PWV) in chronic kidney disease and HD patients, also arterial stiffness was strongly associated with cardiovascular disease - Seemore at.