Abstract
Introduction Chronic kidney disease (CKD) is associated with high mortality rates, mainly as a result of cardiovascular complications. Meanwhile, recent studies have suggested a role of a homodimer protein called activin A in chronic kidney disease-mineral and bone disorder (CKD-MBD) conditions that may exist in the vascular calcification and osteolytic process. Ultrasound examination of the carotid intima-media thickness (cIMT) is a noninvasive method to assess vascular calcification. This study aimed to analyze the relationship between the activin A serum level and cIMT in patients with CKD at Mohammad Hoesin Hospital, Palembang, Indonesia. Methods We conducted a hospital-based, cross-sectional study of consecutive CKD patients at the Department of Internal Medicine, Mohammad Hoesin Hospital, from July to November 2019. The level of activin A was measured by enzyme-linked immunosorbent assay. Meanwhile, cIMT measurements were collected by B-mode ultrasound imaging. Results A total of 55 patients with CKD were included in this investigation. The median serum activin A level in these patients was 236.17 (116.33–283) pg/mL, while the median cIMT was 0.8 (0.6–1.45) mm. A relationship between the serum activin A level and cIMT (r = 0.449; p = 0.001) was observed. During multivariate analysis with linear regression, triglyceride (p = 0.049), phosphate (p = 0.005), and activin A (p = 0.020) serum levels were factors associated with cIMT. Conclusion In this study, a relationship between the activin A serum level and cIMT in patients with CKD was identified. Vascular calcification should be screened for in all CKD patients by the measurement of cIMT.
Highlights
Chronic kidney disease (CKD) is associated with high mortality rates, mainly as a result of cardiovascular complications
Chronic kidney disease (CKD) is associated with high mortality rates attributed to the onset of cardiovascular complications. e risk of death exceeds that of type 2 diabetes mellitus and is linked to the mineral and bone disorders (MBD) that occur when suffering from CKD [1]
ActRllA is a receptor for transforming growth factor-β protein family ligands [7, 8] whose activation enhances vascular calcification, while its signal inhibition restores conditions in the CKD model mice [7]. e study by Agapova et al serves to increase the interest in International Journal of Nephrology researching the role of activin A as the most recent biomarker identified in chronic kidney diseasemineral and bone disorder (CKD-MBD)
Summary
Chronic kidney disease (CKD) is associated with high mortality rates attributed to the onset of cardiovascular complications. e risk of death exceeds that of type 2 diabetes mellitus and is linked to the mineral and bone disorders (MBD) that occur when suffering from CKD [1]. Materials and Methods e present investigation was a hospital-based, cross-sectional consecutive study performed in the Department of Internal Medicine, Mohammad Hoesin Hospital, Palembang, Indonesia, from July to November 2019 Eligible patients were those older than 18 years with CKD diagnosed according to the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative guidelines and who were willing to participate by signing an informed consent form. Activin A levels were measured with the enzyme-linked immunosorbent assay sandwich technique using human activin A reagent from Cloud-Clone Corporation (Houston, TX, USA), while the cIMT examination was conducted using B-mode ultrasonography (Phillips Affinity 50) by a cardiovascular consultant Laboratory assessments such as urea, creatinine, calcium, phosphate, cholesterol, and parathyroid hormone levels were performed on the same day as activin A and cIMT tests. All statistical analyses were conducted using the Statistical Package for the Social Sciences version 19 (IBM Corporation, Armonk, NY, USA), where p < 0.05 was considered to be statistically significant
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