Browsing by Author "Kirkpantur, Alper"

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    Independent association between serum sclerostin levels and carotid artery atherosclerosis in prevalent haemodialysis patients
    (OXFORD UNIV PRESS, 2015-01-01) Kirkpantur, Alper; Balci, Mustafa; Turkvatan, Aysel; Afsar, Baris
    Background: Sclerostin is a soluble inhibitor of the Wntsignalling pathway and has been shown to be associated with decreased bone turnover and vascular and/or valvular calcification in patients with chronic kidney disease. Common carotid artery intima-media thickness (CIMT) assessment and common carotid artery (CCA) plaque identification with ultrasound imaging are well-recognized tools for the identification and monitoring of atherosclerosis. The aim of the present study was to investigate whether the circulating levels of sclerostin might be associated with carotid artery atherosclerosis in prevalent haemodialysis patients. Methods: In this cross-sectional study, serum sclerostin concentrations were measured using a commercially available enzyme-linked immunosorbent assay kit. CIMT was measured and carotid plaques were identified by B-mode and Doppler ultrasound imaging. Results: One hundred and twenty-two prevalent haemodialysis patients were involved in the study. Serum sclerostin levels were higher in patients with plaques in CCA than patients free of plaques ( 227 +/- 166 versus 117 +/- 91 pmol/L, P = 0.016). A significant correlation was recorded between serum sclerostin levels and CIMT (r = 0.459, P < 0.0001). In the multiple regression analysis, sclerostin concentrations were one of the independent factors that remained significantly associated with CIMT. Conclusion: Sclerostin is independently associated with CIMT although further studies are needed.
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    Serum sclerostin levels, arteriovenous fistula calcification and 2-years all-cause mortality in prevalent hemodialysis patients
    (SOC ESPANOLA NEFROLOGIA DR RAFAEL MATESANZ, 2016-01-01) Kirkpantur, Alper; Balci, Mustafa; Turkvatan, Aysel; Afsar, Baris
    Background: Bone and mineral abnormalities, and cardiovascular calcification are associated with increased cardiovascular mortality in patients with chronic kidney disease (CKD). Recent studies have implicated Wnt signaling pathway in the pathogenesis of bone metabolism and vascular calcification. Sclerostin is a soluble inhibitor of Wnt signaling pathway and has been shown to be associated with decreased bone tumover and vascular calcification in CKD patients. Objectives: The aim was to investigate whether the circulating levels of sclerostin are associated with all-cause mortality in prevalent hemodialysis patients. Methods: Data are prospectively collected for 24 months for survival analysis in 350 prevalent hemodialysis patients. At baseline, serum sclerostin levels were measured and arteriovenous fistula calcification was detected by using a 64-detector computerized tomographic scanner. Results: During the follow-up, 84 (24\%) patients died. Patients who died had higher serum sclerostin levels. Kaplan Meier curve revealed that patients with increasing tertiles of serum sclerostin levels at baseline, had a worse survival. In the multivariate Cox regression analysis age, albumin, and presence of arteriovenous fistula calcification, but not sclerostin levels, were found to be independent predictors of survival in maintenance hemodialysis patients. Conclusion: Further clinical studies with longer follow-up are needed to clarify the impact of serum sclerostin levels on morbidity and mortality of maintenance hemodialysis patients. Clinical trial registration number: The study was performed as a post hoc survival analysis of the patients involved in a single-center prospective trial investigating the association between serum sclerostin levels and arteriovenous fistula calcification and patency {[}Balm M, et al. Herz 2015