The relationship between serum fetuin A levels and vasculer calcification in patients with cronic renal failure at different stage

Introduction: The mortality and morbidity rates due to cardiovascular diseases among young adults with chronic renal failure are disproportionally elevated when compared to their healthy counterparts. Vascular calcifications caused by chronic inflammation could be the reason of the decreased life span and prevalant morbidity in these patients.Objective: The aim of this study was to investigate the relation between fetuin A and cardiovascular calcification parameters in children with different stages of chronic renal failure (CRF).Material and methods: Ninety patients and 40 healthy age and sex-matched controls were included in the study. The patient population consisted of 54 children with stages 2-4 chronic renal failure (CRF) and 36 patients with end stage renal failure (ESRD), of which 23 were on peritoneal dialysis and 13 patients were on hemodialysis. In all subjects serum fetuin A, various inflammation markers (ferritin, CRP, fibrinogen, albumin), homocysteine levels, lipid profiles, and carotis intima media thickness were studied.Results: Serum fetuin A levels were found to be significantly lower in patients with ESRD and CRF than in healthy controls (p=0,002 and p=0,041 respectively). There was no significant difference in fetuin A between patients with ESRD and CRF. Serum ferritin, CRP, fibrinogen, and homocysteine levels were significantly higher (p<0,001, p=0,001, p=0,003, p=0,010) and albumin was significantly lower (p<0,001) in CRF and ESRD patients than in healthy controls. Ferritin was significantly higher (p<0,001) and albumin was significantly lower (p=0,012) in ESRD patients than in CRF patients. Carotis intima media thickness was not significantly different between the groups. No significant correlation was found between carotis intima media thickness and the studied parameters.Conclusion: Having elevated markers of chronic inflammation and decreased serum fetuin levels these children with CRF and ESRD may be at an increased risk of vascular calcification. Further longitudinal studies are needed for decreasing chronic inflammation in these children.Keywords: Children, fetuin A, inflammation, renal failure, vasculer calcification,