Osteoprotegerin and mortality in hemodialysis patients with cardiovascular disease

Simon Winther, Jeppe Hagstrup Christensen, Allan Flyvbjerg, Erik Berg Schmidt, Kaj Anker Jørgensen, Hanne Skou-Jørgensen, My Svensson

15 Citations (Scopus)


BACKGROUND: Patients treated with hemodialysis (HD) have an increased mortality, mainly caused by cardiovascular disease (CVD). Osteoprotegerin (OPG) is a glycoprotein involved in the regulation of the vascular calcification process. Previous studies have demonstrated that OPG is a prognostic marker of mortality. The aim of this study was to investigate if OPG was a prognostic marker of all-cause mortality in high-risk patients with end-stage renal disease and CVD.

METHODS: We prospectively followed 206 HD patients with CVD. OPG was measured at baseline and the patients were followed for 2 years or until reaching the primary endpoint, i.e., all-cause mortality.

RESULTS: All-cause mortality during follow-up was 44% (90/206). High OPG was associated with increased mortality, using the first tertile as reference, with an unadjusted HR of 1.70 (CI 1.00 - 2.88) for the second tertile and HR of 1.63 (CI 0.96 - 2.78) for the third tertile. In a multivariate Cox-regression analysis age, CRP and OPG in both the second and third tertile were significantly associated with increased mortality In the unadjusted survival analysis, a test for trend of OPG yielded a p-value of 0.08; in the adjusted analyses, the p-value for trend was 0.03.

CONCLUSIONS: In a high-risk population of hemodialysis patients with previously documented cardiovascular disease, a high level of OPG was an independent risk marker of all-cause mortality.

Original languageEnglish
JournalClinical Nephrology
Issue number3
Pages (from-to)161-7
Number of pages7
Publication statusPublished - Sep 2013
Externally publishedYes


  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Cardiovascular Diseases
  • Chi-Square Distribution
  • Denmark
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Osteoprotegerin
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Dialysis
  • Risk Assessment
  • Risk Factors
  • Secondary Prevention
  • Time Factors
  • Treatment Outcome
  • Up-Regulation
  • Journal Article
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't


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