Abstract: TH-PO149
Mineral Bone Disease (MBD) and Glycocalyx Injury in CKD in the Dallas Heart Study (DHS)
Session Information
- CKD-MBD: Clinical
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Watanabe, Shota, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Van Buren, Peter N., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
Background
MBD in CKD causes vascular calcification as a cardiovascular (CV) disease mediator. High phosphate (Ph) and parathyroid hormone (PTH) promote calcification, while osteopontin (OPN) is a calcification inhibitor. In dialysis patients, high Ph also associates with endothelial cell dysfunction (ECD), which may further increase CV risk. We aimed to determine how OPN, Ph, and PTH associated with syndecan-1 (SDC1), an endothelial glycocalyx injury marker, in CKD patients enrolled in a large multiethnic cohort study.
Methods
We retrospectively analyzed baseline data of CKD patients (estimated glomerular filtration rate [eGFR] <60 mL/min or urine albumin/creatinine [UACR] >30 mg/g) enrolled in DHS. We used Pearson correlation for associations between serum SDC1, OPN, PTH, Ph, eGFR, UACR, and age. We used all variables in a linear regression model with SDC1 as the outcome also controlling for race, sex, and diabetes.
Results
In 171 participants (Table1), mean age was 47.9 (9) years, mean eGFR 86.0 (34) mL/min, and median UACR 59.5 (35, 198) mg/g. Log SDC1 correlated with log OPN (r=0.8, p<.0001; Fig1), log PTH (r=0.2, p=.03), and eGFR (r=-0.2, p=.004). OPN independently predicted SDC1 (β=0.6, p<0.001), but Ph and log PTH (p=.1, p=.2) did not.
Conclusion
In CKD patients (mostly early CKD), OPN independently and strongly predicted SDC1, an endothelial glycocalyx injury marker. While OPN inhibits calcification in the context of MBD, it may exacerbate ECD even in early CKD.
Patient Characteristics (n=171)
| Age (years) | 47.9 (9.0) |
| Number (%) male | 82 (48%) |
| Number (%) Black race | 114 (67%) |
| Number (%) with diabetes | 56 (33%) |
| Body Mass Index (kg/m2) | 30.8 (26, 36) |
| Serum Syndecan-1 (ng/mL; median, IQR) | 3.42 (2.3, 5.0) |
| Serum Osteopontin (ng/mL; median, IQR) | 44.8 (29, 73) |
| Estimated MDRD glomerular filtration rate (mL/min; mean, SD) | 86.0 (34) |
| Urine albumin/creatinine (mg/g; median, IQR) | 59.5 (35, 200) |
| Serum Intact parathyroid hormone (pg/mL; median, IQR) | 43.1 (28, 61) |
| Serum phosphate (mg/dL; median, IQR) | 3.3 (2.9, 3.8) |
Funding
- NIDDK Support