Relationship of sRANKL level and vascular calcification score to cardiovascular events in maintenance hemodialysis patients.

摘要

BACKGROUND: Vascular calcification and cardiovascular events are common in hemodialysis patients. Receptor activator of nuclear factor-kappaB ligand (RANKL) plays an important role in vascular calcification and bone remodeling. This study investigates the effects of soluble RANKL (sRANKL) on cardiovascular events in hemodialysis patients. METHODS: Serum sRANKL levels of 47 patients were tested by ELISA. Vascular calcification was radiographically measured and patients were followed up for 2 years. RESULTS: After 2 years, 10 (36.6%) patients had experienced cardiovascular events. Seventy-five percent (6/9) of mortality was due to cardiovascular disease. Patients experiencing cardiovascular events showed significantly higher vascular calcification scores (VCS) (3.20 +/- 2.74 vs. 1.19 +/- 1.60; t = 2.999; p < 0.05). Multivariate regression analysis showed that serum sRANKL levels, vascular calcification scores and phosphorus were independent determinants of cardiovascular events. CONCLUSION: Serum sRANKL levels and VCS are independent risk factors, and hemodialysis patients with low serum sRANKL levels have a risk of cardiovascular events.