Sclerostin is an independent risk factor for all-cause mortality in kidney transplant recipients
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ORIGINAL ARTICLE
Sclerostin is an independent risk factor for all‑cause mortality in kidney transplant recipients Shufei Zeng1,2 · Torsten Slowinski1 · Wolfgang Pommer3 · Ahmed A. Hasan2,4 · Mohamed M. S. Gaballa2,4,5 · Yongping Lu2,6 · Bernhard K. Krämer2 · Berthold Hocher2,7,8,9 Received: 11 February 2020 / Accepted: 7 August 2020 © The Author(s) 2020
Abstract Background Sclerostin is a hormone contributing to the bone-vascular wall cross talk and has been implicated in cardiovascular events and mortality in patients with chronic kidney disease (CKD). We analyzed the relationship between sclerostin and mortality in renal transplant recipients. Methods 600 stable renal transplant recipients (367men, 233 women) were followed for all-cause mortality for 3 years. Blood and urine samples for analysis and clinical data were collected at study entry. We performed Kaplan–Meier survival analysis and Cox regression models considering confounding factors such as age, eGFR, cold ischemia time, HbA1c, phosphate, calcium, and albumin. Optimal cut-off values for the Cox regression model were calculated based on ROC analysis. Results Sixty-five patients died during the observation period. Nonsurvivors (n = 65; sclerostin 57.31 ± 30.28 pmol/L) had higher plasma sclerostin levels than survivors (n = 535; sclerostin 47.52 ± 24.87 pmol/L) (p = 0.0036). Kaplan–Meier curve showed that baseline plasma sclerostin concentrations were associated with all-cause mortality in stable kidney transplant recipients (p = 0.0085, log-rank test). After multiple Cox regression analysis, plasma levels of sclerostin remained an independent predictor of all-cause mortality (hazard ratio, 1.011; 95% CI 1.002–1.020; p = 0.0137). Conclusions Baseline plasma sclerostin is an independent risk factor for all-cause mortality in patients after kidney transplantation. Keywords Kidney transplantation · All-cause mortality · Sclerostin
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10157-020-01956-y) contains supplementary material, which is available to authorized users. * Berthold Hocher [email protected]‑heidelberg.de 1
Department of Nephrology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany
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3
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KfH Kuratorium für Dialyse und Nierentransplantation e.V., Bildungszentrum, Neu‑Isenburg, Germany Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
Kidney transplant recipients are a subset of patients with chronic kidney disease (CKD). And kidney transplantation is the treatment of choice for end-stage renal disease [1].
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Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Egypt
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Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
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Institute of Medical Diagnostics, IMD Berlin, Ber
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