Higher sclerostin is associated with pulmonary hypertension in pre-dialysis end-stage kidney disease patients: a cross-sectional prospective observational cohort studyopen access
- Authors
- Lee, Jonghyun; Cho, Dong-Hyuk; Min, Hyeon-Jin; Son, Young-Bin; Kim, Tae Bum; Oh, Se Won; Kim, Myung-Gyu; Cho, Won Yong; Jo, Sang-Kyung; Yang, Jihyun
- Issue Date
- Feb-2024
- Publisher
- BioMed Central
- Keywords
- Chronic kidney disease; End-stage kidney disease; Mortality; Pulmonary hypertension; Wnt signaling
- Citation
- BMC Pulmonary Medicine, v.24, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- BMC Pulmonary Medicine
- Volume
- 24
- Number
- 1
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65665
- DOI
- 10.1186/s12890-024-02871-8
- ISSN
- 1471-2466
- Abstract
- Background Pulmonary hypertension (PH) is a complication of chronic kidney disease (CKD) that contributes to mortality. Sclerostin, a SOST gene product that reduces osteoblastic bone formation by inhibiting Wnt/beta-catenin signaling, is involved in arterial stiffness and CKD-bone mineral disease, but scanty evidence to PH. This study explored the relationship between sclerostin and PH in CKD 5, pre-dialysis end-stage kidney disease (ESKD) patients. Methods This cross-sectional prospective observational cohort study included 44 pre-dialysis ESKD patients between May 2011 and May 2015. Circulating sclerostin levels were measured using an enzyme-linked immunosorbent assay. PH was defined as an estimated pulmonary artery systolic pressure > 35 mmHg on echocardiography. Results Patients with higher sclerostin levels >= 218.18pmol/L had echocardiographic structural cardiac abnormalities, especially PH (P < 0.01). On multivariate logistic analysis, sclerostin over 218.19pmol/L was significantly associated with PH (odds ratio [OR], 41.14; 95% confidence interval [CI], 4.53-373.89, P < 0.01), but multivariate Cox regression analysis showed the systemic vascular calcification score over 1 point (Hazard ratio [HR] 11.49 95% CI 2.48-53.14, P = 0.002) and PH ([HR] 5.47, 95% CI 1.30-23.06, P = 0.02) were risk factors for all-cause mortality in pre-dialysis ESKD patients. Conclusions Serum sclerostin and PH have a positive correlation in predialysis ESKD patients. The higher systemic vascular calcification score and PH have an association to increase all-cause mortality in pre-dialysis ESKD patients.
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