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Factors associated with serum fetuin-A concentrations after long-term use of different phosphate binders in hemodialysis patients.
BMC Nephrol. 2016 Mar 23; 17:33.BN

Abstract

BACKGROUND

Fetuin-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.

METHODS

In 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.

RESULTS

After 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.

CONCLUSION

After 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.

Authors+Show Affiliations

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.Hsin-Jen Hospital, Taipei, Taiwan.Division of Nephrology, National Taiwan University Hospital, Taipei, Taiwan.The Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung, Taiwan. cch@mail.cmuh.org.tw. Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan. cch@mail.cmuh.org.tw.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27007989

Citation

Lin, Hsin-Hung, et al. "Factors Associated With Serum fetuin-A Concentrations After Long-term Use of Different Phosphate Binders in Hemodialysis Patients." BMC Nephrology, vol. 17, 2016, p. 33.
Lin HH, Liou HH, Wu MS, et al. Factors associated with serum fetuin-A concentrations after long-term use of different phosphate binders in hemodialysis patients. BMC Nephrol. 2016;17:33.
Lin, H. H., Liou, H. H., Wu, M. S., & Huang, C. C. (2016). Factors associated with serum fetuin-A concentrations after long-term use of different phosphate binders in hemodialysis patients. BMC Nephrology, 17, 33. https://doi.org/10.1186/s12882-016-0245-3
Lin HH, et al. Factors Associated With Serum fetuin-A Concentrations After Long-term Use of Different Phosphate Binders in Hemodialysis Patients. BMC Nephrol. 2016 Mar 23;17:33. PubMed PMID: 27007989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with serum fetuin-A concentrations after long-term use of different phosphate binders in hemodialysis patients. AU - Lin,Hsin-Hung, AU - Liou,Hung-Hsiang, AU - Wu,Ming-Shiou, AU - Huang,Chiu-Ching, Y1 - 2016/03/23/ PY - 2015/05/30/received PY - 2016/03/17/accepted PY - 2016/3/24/entrez PY - 2016/3/24/pubmed PY - 2016/10/8/medline KW - CKD KW - ESRD KW - Fetuin-A KW - Hemodialysis KW - Phosphate binder KW - Sevelamer SP - 33 EP - 33 JF - BMC nephrology JO - BMC Nephrol VL - 17 N2 - BACKGROUND: Fetuin-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. METHODS: In 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. RESULTS: After 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. CONCLUSION: After 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. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/27007989/Factors_associated_with_serum_fetuin_A_concentrations_after_long_term_use_of_different_phosphate_binders_in_hemodialysis_patients_ DB - PRIME DP - Unbound Medicine ER -