Osteoprotegerin and Vascular Dysfunction in Patients With Stage 3 Chronic Kidney Disease and Those Without Renal Dysfunction: a Case-control Study (Nefrovasc Study)

Abstract

Abstract Background: Osteoprotegerin (OPG) is a marker of vascular calcification and cardiovascular (CV) risk in patients with chronic kidney disease (CKD). The study aimed to compare OPG values with flow-mediated dilation (FMD) and pulse wave velocity (PWV) and to evaluate the correlation between these measures in patients in stage 3 CKD and those without renal dysfunction. Methods: This case-control study was conducted in a specialized hypertension clinic in 2022. A total of 79 patients over 18 years of age participated in the study. The case group consisted of 30 patients who had moderate renal dysfunction (CKD stage 3a and 3b) and the control group included 49 individuals with GFR ≥60 ml/min/1.73 m2. For the comparative analysis between patients with and without renal dysfunction, qualitative variables were analyzed using the chi-square test, while quantitative variables were evaluated using the independent t-test or Mann-Whitney test. The linear correlation between OPG and the other variables was analyzed using Pearson's or Spearman's correlation tests. Results: Central pulse pressure (cPP), PWV, and augmentation index (AIx) were higher in patients with renal dysfunction. The serum OPG level positively correlated with peripheral and central systolic blood pressure (BP), PPc, PWV, and AIx. Conversely, the serum OPG did not correlate with FMD. Conclusions: OPG and PWV are possible biomarkers of vascular dysfunction that are altered in patients with moderate renal dysfunction. This study is has limitations: is a case-control study conducted at a single center with a small number of patients with CKD.