Abstract
Circulating osteoprotegerin (OPG) is a biomarker for cardiovascular complications that are closely related to chronic kidney disease (CKD). To investigate the association between circulating OPG level with long-term visit-to-visit blood pressure variability (BPV) in patients with pre-dialysis CKD, a total of 1855 subjects with CKD from stage 1 to pre-dialysis stage 5 from a prospective cohort were analyzed. Long-term visit-to-visit BPV was determined by average real variability (ARV), standard deviation (SD), and coefficient of variation (CoV) of systolic and diastolic blood pressure (SBP and DBP). ARV of SBP (Adjusted β coefficient 0.143, 95% confidence interval 0.021 to 0.264) was significantly associated with serum OPG level. Although SD and CoV of SBP were not significantly associated with serum OPG level in multivariate linear regression analyses, restricted cubic spline visualized the linear correlation of serum OPG level with all of ARV, SD, and CoV. The association between serum OPG level and DBP variability was not significant. Subgroup analyses revealed that the association of serum OPG with BPV is more prominent in the subjects with Charlson comorbidity index ≤3 and in the subjects without history of diabetes mellitus. In conclusion, circulating OPG level is potentially associated with long-term visit-to-visit BPV in patients with pre-dialysis CKD.
Highlights
The proportion of the subjects with DM increased as serum OPG level increased, whereas the proportion of the subjects with glomerulonephritis or polycystic kidney disease decreased as serum
We found a significant association between circulating OPG level and long-term visit-to-visit blood pressure variability (BPV) in patients with pre-dialysis chronic kidney disease (CKD)
The results indicate an independent association of serum OPG level and BPV, a possibility cannot be still excluded that the factors other than BPV may have some effects on serum OPG levels, because the baseline characteristics were strikingly differed by serum OPG levels
Summary
Outcomes, as it predicts the risk of CV events and all-cause mortality in general population [1,2,3], independent of mean blood pressure (BP). Among patients with chronic kidney disease (CKD), long-term visit-to-visit BPV is associated with adverse CV outcomes [4]. Visit-to-visit BPV increases the risk of incident CKD in hypertensive individuals [5]. CV events are the leading cause of death in patients with reduced kidney function [9], the 4.0/). Prediction of long-term BPV is becoming more and more important in the management of CKD patients. OPG inhibits RANKL-mediated differentiation of osteoclast as well as activation and survival of mature osteoclasts [11], playing a pivotal role in the regulation of bone turnover. Previous studies demonstrated that high serum OPG level is associated with the presence [15]
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