Serum osteoprotegerin is associated with pulse pressure in kidney transplant recipients

Gender-Related Differences in Chronic Kidney Disease-Associated Vascular Calcification Risk and Potential Risk Mediators: A Scoping Review

Vascular calcification (VC) involves the deposition of calcium apatite in vascular intima or media. Individuals of advanced age, having diabetes mellitus or chronic kidney disease (CKD) are particularly at risk. The pathogenesis of CKD-associated VC evolves considerably. The core driver is the phenotypic change involving vascular wall constituent cells toward manifestations similar to that undergone by osteoblasts. Gender-related differences are observed regarding the expressions of osteogenesis-regulating effectors, and presumably the prevalence/risk of CKD-associated VC exhibits gender-related differences as well. Despite the wealth of data focusing on gender-related differences in the risk of atherosclerosis, few report whether gender modifies the risk of VC, especially CKD-associated cases. We systematically identified studies of CKD-associated VC or its regulators/modifiers reporting data about gender distributions, and extracted results from 167 articles. A significantly higher risk of CKD-associated VC was observed in males among the majority of original investigations. However, substantial heterogeneity exists, since multiple large-scale studies yielded neutral findings. Differences in gender-related VC risk may result from variations in VC assessment methods, the anatomical segments of interest, study sample size, and even the ethnic origins of participants. From a biological perspective, plausible mediators of gender-related VC differences include body composition discrepancies, alterations involving lipid profiles, inflammatory severity, diversities in matrix Gla protein (MGP), soluble Klotho, vitamin D, sclerostin, parathyroid hormone (PTH), fibroblast growth factor-23 (FGF-23), and osteoprotegerin levels. Based on our findings, it may be inappropriate to monotonously assume that male patients with CKD are at risk of VC compared to females, and we should consider more background in context before result interpretation.

Association between serum osteoprotegerin level and mortality in kidney transplant recipients - a prospective observational cohort study

Paradoxically, higher serum levels of osteoprotegerin (OPG: a vascular calcification inhibitor) have been associated with increased arterial stiffness, risk of cardiovascular disease and all-cause mortality. A few studies reported that post-transplant OPG levels are associated with mortality in kidney transplant (KT) recipients. In this study, this association was assessed in a cohort of prevalent KT recipients, adjusting for previously untested potential confounders, including fibroblast growth factor 23 (FGF23) and interleukin 6 (IL-6). Socio-demographic and clinical parameters, medical and transplant history, and laboratory data were collected from 982 prevalent KT recipients. The association between serum OPG and all-cause mortality over a 6-year follow-up period was examined using Kaplan-Meier survival curves and multivariable-adjusted Cox regression models. Participants with high serum OPG were more likely female, older, deceased donor KT recipients and have more comorbidity, lower eGFR, higher FGF23, higher IL-6, and longer dialysis vintage. Each 1 pmol/l higher serum OPG level was associated with a 49% higher risk of mortality (hazard ratio (HR) [95% confidence interval (CI)]: 1.49 [1.40-1.61]). This association persisted after adjusting for confounders (HR [95% CI]: 1.20 [1.10-1.30]). In conclusion, serum OPG was associated with all-cause mortality independent of several novel confounders in prevalent KT recipients.

The Correlation of Serum Osteoprotegerin with Non-Traditional Cardiovascular Risk Factors and Arterial Stiffness in Patients with Pre-Dialysis Chronic Kidney Disease: Results from the KNOW-CKD Study

BACKGROUND

Osteoprotegerin (OPG) plays protective roles against the development of vascular calcification (VC) which greatly contributes to the increased cardiovascular events in patients with chronic kidney disease (CKD). The present study aimed to find the non-traditional, kidney-related cardiovascular risk factors correlated to serum OPG and the effect of serum OPG on the arterial stiffness measured by brachial ankle pulse wave velocity (baPWV) in patients with the pre-dialysis CKD.

METHODS

We cross-sectionally analyzed the data from the patients in whom baPWV and the serum OPG were measured at the time of enrollment in a prospective pre-dialysis CKD cohort study in Korea.

RESULTS

Along with traditional cardiovascular risk factors such as age, diabetes mellitus, pulse pressure, and baPWV, non-traditional, kidney-related factors such as albuminuria, plasma level of hemoglobin, total CO₂ content, alkaline phosphatase, and corrected calcium were independent variables for serum OPG in multivariate linear regression. Reciprocally, the serum OPG was positively associated with baPWV in multivariate linear regression. The baPWV in the 3rd and 4th quartile groups of serum OPG were higher than that in the 1st quartile group after adjustments by age, sex and other significant factors for baPWV in linear mixed model.

CONCLUSION

Non-traditional, kidney-related cardiovascular risk factors in addition to traditional cardiovascular risk factors were related to serum level of OPG in CKD. Serum OPG level was significantly related to baPWV. Our study suggests that kidney-related factors involved in CKD-specific pathways for VC play a role in the increased secretion of OPG into circulation in patients with CKD.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01630486.

Nanodiamonds conjugated to gold nanoparticles for colorimetric detection of clenbuterol and chromium(III) in urine

Nanodiamonds were modified such that they carry thiol groups (ND-thiol). Gold nanoparticles were reacted with ND-thiol to obtain a highly stable conjugate of the type ND@AuNPs. Both ND-thiol and the ND@AuNPs were characterized by SEM, TEM, AFM, DLS, zeta potential, XPS, XRD, UV-Vis, Raman, FTIR and cytotoxicity studies. Their biocompatibility was confirmed via an MTT assay with HeLa cells. At a pH value of 6, the ND@AuNPs represent a colorimetric probe that can be used to selectively detect the illegally used β-adrenergic drug clenbuterol (CLB) and the pollutant chromium(III). Detection can be performed visually by monitoring the color change from wine red to purple blue, or by colorimetric measurement of the so-called SPR peaks at 651 and 710 nm. The color changes are due to aggregation, and this is confirmed by TEM and DLS data. The involvement of surface functional groups that assist in analyte recognition was verified by FTIR. The detection limits are 0.49 nM for CLB, and 0.37 nM for Cr(III). The ND@AuNPs were successfully applied to the determination of Cr(III) and CLB in spiked human urine samples. Notably, the low interference by other ions in the detection of Cr(III) in tap and lake water is confirmed by ICP-MS analyses. Graphical abstract Nanodiamonds carrying thiol groups (ND-Thiol) were conjugated to gold nanoparticles, and the resulting ND@AuNPs are shown to be viable probes for the colorimetric detection of sub-nanomolar levels of clenbuterol (CLB) and Cr(III) ions, with demonstrated applicability to real water and urine samples.

An Affordable Wet Chemical Route to Grow Conducting Hybrid Graphite-Diamond Nanowires: Demonstration by A Single Nanowire Device

We report an affordable wet chemical route for the reproducible hybrid graphite-diamond nanowires (G-DNWs) growth from cysteamine functionalized diamond nanoparticles (ND-Cys) via pH induced self-assembly, which has been visualized through SEM and TEM images. Interestingly, the mechanistic aspects behind that self-assembly directed G-DNWs formation was discussed in details. Notably, above self-assembly was validated by AFM and TEM data. Further interrogations by XRD and Raman data were revealed the possible graphite sheath wrapping over DNWs. Moreover, the HR-TEM studies also verified the coexistence of less perfect sp² graphite layer wrapped over the sp³ diamond carbon and the impurity channels as well. Very importantly, conductivity of hybrid G-DNWs was verified via fabrication of a single G-DNW. Wherein, the better conductivity of G-DNW portion L2 was found as 2.4 ± 1.92 × 10⁻⁶ mS/cm and revealed its effective applicability in near future. In addition to note, temperature dependent carrier transport mechanisms and activation energy calculations were reported in details in this work. Ultimately, to demonstrate the importance of our conductivity measurements, the possible mechanism behind the electrical transport and the comparative account on electrical resistivities of carbon based materials were provided.

Does the OPG/RANKL system contribute to the bone-vascular axis in chronic kidney disease? A systematic review

Vascular calcification (VC) is highly prevalent in patients with chronic kidney disease (CKD) and is strongly associated with cardiovascular mortality and morbidity. Accumulating evidence over the past decade has challenged the hypothesis of close interaction between bone and VC what raises the possibility of a common underlying pathophysiological mechanism. Lately, bone regulatory proteins such as: osteoprotegerin (OPG) and Receptor Activator for Nuclear Factor κB Ligand (RANKL) has attracted attention of researchers as a possible key mediators of bone-vascular calcification imbalance. The literature search was carried out using the MEDLINE/PubMed database and a combination of keywords and MeSH terms, and only papers published since January 2005 to July 2016 were selected. The search resulted in 562 potential articles. After selection according to the eligibility criteria, 107 studies fulfilled were included (102 full texts and 5 was case reports). OPG and RANKL plays essential role in the regulation of bone metabolism and may be regarded as a possible link between VC, bone and mineral metabolism in CKD patients. Further studies are required to determine the diagnostic significance of these proteins in evaluation of progression and severity of VC process in CKD patients. Finally, the efficacy and safety, especially in regard to VC, of anti-RANKL therapy in CKD patients requires well-designed prospective, randomized trials.