Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 11-12, Pages: 608-614
https://doi.org/10.2298/SARH1612608P
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Prevalence and risk factors of vascular calcification in pre-dialysis patients with Balkan endemic nephropathy
Petković Nenad (Fresenius Medical Care Dialysis Center, Šamac, Republic of Srpska, Bosnia and Herzegovina)
Marić Radmil (University of East Sarajevo, Faculty of Medicine, Foča, Republic of Srpska, Bosnia and Herzegovina)
Gajanin Radoslav (University of Banja Luka, Faculty of Medicine, Department of Pathology, Banja Luka, Republic of Srpska, Bosnia and Herzegovina)
Batinić Danijela (University of East Sarajevo, Faculty of Medicine, Foča, Republic of Srpska, Bosnia and Herzegovina)
Ćuk Mirjana (University of East Sarajevo, Faculty of Medicine, Foča, Republic of Srpska, Bosnia and Herzegovina)
Ristić Siniša (University of East Sarajevo, Faculty of Medicine, Foča, Republic of Srpska, Bosnia and Herzegovina)
Đukanović Ljubica (School of Medicine, Belgrade)
Introduction. Vascular calcifications (VC) are common in patients with
chronic kidney disease and present one of manifestations of mineral and bone
disorders in these patients. Objective. The aim of this pilot study was to
examine the prevalence and risk factors of VC in pre-dialysis patients with
Balkan endemic nephropathy (BEN) and other kidney diseases. Methods. The
study involved 32 pre-dialysis patients, 15 with BEN and 17 with other kidney
diseases. All the patients underwent an interview, objective examination,
routine laboratory analyses and measurement of serum concentration of intact
parathyroid hormone (iPTH), 25-hydroxyvitamin D3 [25(OH)D3] and osteopontin.
VCs in iliac, femoral, radial, and digital arteries were evaluated and
Adragao VC score was calculated. The samples of radial artery were collected
during the first creation of an arteriovenous fistula, and expression of
osteocalcin, bone morphogenic protein-2 osteopontin, and matrix Gla-protein
in arterial wall were examined. Results. Patients with BEN were significantly
older (71.1 ± 6.1 vs. 54.7 ± 11.1 years), but they had significantly lower
systolic and mean blood pressure (95.7 ± 13.2 mmHg vs. 104.3 ± 7.4 mmHg) and
lower serum concentration of phosphorus (1.32 ± 0.36 mmol/l vs. 1.65 ± 0.35
mmol/l) and cholesterol (4.3 ± 1.1 mmol/l vs. 5.2 ± 0.8 mmol/l) than patients
with other kidney diseases. Mean VC score was significantly lower in patients
with BEN than in those with other kidney diseases (2.8 ± 1.7 vs. 4.6 ± 1.8; p
= 0.009), but expression of four examined proteins in arterial wall differed
insignificantly between the two groups. VC score correlated significantly
with serum concentrations of cholesterol, triglycerides (positively), and
iPTH (negatively). Conclusion. Pre-dialysis BEN patients had a significantly
lower mean score of VC than patients with other kidney diseases.
Keywords: vascular calcification, pre-dialysis patients, Balkan endemic nephropathy
Projekat
Ministarstva nauke Republike Srbije, br. 175025