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Torino C, Carbone F, Pizzini P, Mezzatesta S, D’Arrigo G, Gori M, Liberale L, Moriero M, Michelauz C, Frè F, Isoppo S, Gavoci A, Rosa FL, Scuricini A, Tirandi A, Ramoni D, Mallamaci F, Tripepi G, Montecucco F, Zoccali C. Osteopontin and Clinical Outcomes in Hemodialysis Patients. Biomedicines 2024; 12:2605. [PMID: 39595171 PMCID: PMC11592156 DOI: 10.3390/biomedicines12112605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 11/06/2024] [Accepted: 11/12/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND/OBJECTIVES Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are significant public health issues, with cardiovascular morbidity and mortality being the leading causes of death in hemodialysis patients. Osteopontin (OPN), a multifunctional glycoprotein, has emerged as a potential biomarker for vascular disease in CKD due to its role in inflammation, tissue remodeling, and calcification. METHODS This cohort study included 1124 hemodialysis patients from the PROGREDIRE study, a registry involving 35 dialysis units in Southern Italy. Serum osteopontin levels were measured using enzyme-linked immunosorbent assay (ELISA). The primary endpoints were all-cause and cardiovascular mortality. Multivariate Cox regression analyses were performed to assess the association between osteopontin levels and mortality, adjusting for traditional risk factors, biomarkers of inflammation, nutritional status, and ESKD-related factors. RESULTS During a mean follow-up of 2.8 years, 478 patients died, 271 from cardiovascular causes. Independent correlates of osteopontin included alkaline phosphatase and parathyroid hormone. Elevated osteopontin levels were significantly associated with increased all-cause mortality (HR 1.19, 95% CI 1.09-1.31, p < 0.001) and cardiovascular mortality (HR 1.22, 95% CI 1.08-1.38, p = 0.001) after adjusting for confounders. CONCLUSIONS Elevated osteopontin levels are associated with increased all-cause and cardiovascular mortality in hemodialysis patients. These findings implicate osteopontin in the high risk for death and cardiovascular disease in the hemodialysis population. Intervention studies are needed to definitively test this hypothesis.
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Affiliation(s)
- Claudia Torino
- Clinical Epidemiology of Renal Disease and Hypertension Unit, Reggio Cal CNR Unit of the Pisa CNR Institute of Clinical Physiology, 89124 Reggio Calabria, Italy; (C.T.); (P.P.); (S.M.); (G.D.); (F.M.); (G.T.)
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
- IRCCS Ospedale Policlinico San Martino, Genoa-Italian Cardiovascular Network, 10 Largo Rosanna Benzi, 16132 Genoa, Italy
| | - Patrizia Pizzini
- Clinical Epidemiology of Renal Disease and Hypertension Unit, Reggio Cal CNR Unit of the Pisa CNR Institute of Clinical Physiology, 89124 Reggio Calabria, Italy; (C.T.); (P.P.); (S.M.); (G.D.); (F.M.); (G.T.)
| | - Sabrina Mezzatesta
- Clinical Epidemiology of Renal Disease and Hypertension Unit, Reggio Cal CNR Unit of the Pisa CNR Institute of Clinical Physiology, 89124 Reggio Calabria, Italy; (C.T.); (P.P.); (S.M.); (G.D.); (F.M.); (G.T.)
| | - Graziella D’Arrigo
- Clinical Epidemiology of Renal Disease and Hypertension Unit, Reggio Cal CNR Unit of the Pisa CNR Institute of Clinical Physiology, 89124 Reggio Calabria, Italy; (C.T.); (P.P.); (S.M.); (G.D.); (F.M.); (G.T.)
| | - Mercedes Gori
- CNR—Institute of Clinical Physiology, 00186 Rome, Italy;
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
- IRCCS Ospedale Policlinico San Martino, Genoa-Italian Cardiovascular Network, 10 Largo Rosanna Benzi, 16132 Genoa, Italy
| | - Margherita Moriero
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Cristina Michelauz
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Federica Frè
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Simone Isoppo
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Aurora Gavoci
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Federica La Rosa
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Alessandro Scuricini
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Amedeo Tirandi
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Davide Ramoni
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
| | - Francesca Mallamaci
- Clinical Epidemiology of Renal Disease and Hypertension Unit, Reggio Cal CNR Unit of the Pisa CNR Institute of Clinical Physiology, 89124 Reggio Calabria, Italy; (C.T.); (P.P.); (S.M.); (G.D.); (F.M.); (G.T.)
- Nephrology, Hypertension and Renal Transplantation Unit, Grande Ospedale Metropolitano, 89124 Reggio Calabria, Italy
| | - Giovanni Tripepi
- Clinical Epidemiology of Renal Disease and Hypertension Unit, Reggio Cal CNR Unit of the Pisa CNR Institute of Clinical Physiology, 89124 Reggio Calabria, Italy; (C.T.); (P.P.); (S.M.); (G.D.); (F.M.); (G.T.)
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; (F.C.); (L.L.); (M.M.); (C.M.); (F.F.); (S.I.); (A.G.); (F.L.R.); (A.S.); (A.T.); (D.R.); (F.M.)
- IRCCS Ospedale Policlinico San Martino, Genoa-Italian Cardiovascular Network, 10 Largo Rosanna Benzi, 16132 Genoa, Italy
| | - Carmine Zoccali
- Renal Research Institute, New York, NY 10065, USA
- IPNET, c/o Nefrologia del Grande Ospedale Metropolitano, 89124 Reggio Calabria, Italy
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