WCN26-4427 Impact of Fractures on Death, Graft loss and Heart Failure After Living-Donor Kidney Transplantation

Introduction: Peripheral arterial stiffness (PAS) is prevalent in chronic kidney disease (CKD) and contributes to cardiovascular risk.We investigated whether circulating osteoprotegerin (OPG), a cytokine linked to vascular calcification, is associated with PAS assessed by brachial-ankle pulse wave velocity (baPWV) in CKD.Methods: In a cross-sectional cohort of 200 adults with CKD, left/right baPWV, clinical characteristics, and serum OPG were measured.The serum OPG levels were measured using a commercial enzyme-linked immunosorbent assay kit.Patients with left or right baPWV >18.0 m/s were classified in the PAS group, whereas those with baPWV # 18.0 m/s were assigned to the control group.Results: Out of 200 non-dialysis CKD patients, 86 (43%) were in PAS groups.Compared with the control group, the rates of diabetes mellitus (DM, P = 0.023), hypertension (P = 0.010), old age (P < 0.001), systolic blood pressures (P < 0.001), spot urine protein-to-creatinine ratio (UPCR, P = 0.004), as well as the serum levels of OPG (P < 0.001), were higher, while estimated glomerular filtration rate (eGFR, P = 0.003) were lower in the PAS group.In fully adjusted models, OPG (per 1 pg/ mL) remained independently associated with PAS (odds ratio [OR]: 1.008, 95% confidence interval [CI]: 1.002-1.015,P = 0.010), along with older age (OR: 1.069, 95% CI: 1.027-1.112,P = 0.001) and DM (OR: 2.745, 95% CI: 1.282-5.876,P = 0.009).Additionally, a positive association was found between the serum logarithmically transformed OPG (log-OPG) levels and either the left or right baPWV (all P < 0.001, respectively) in non-dialysis CKD patients according to the Spearman's rank correlation coefficient test.OPG discriminated PAS with an area under the curve of 0.721 (95% CI: 0.651-0.792,P < 0.0001).Conclusion: In CKD, higher circulating OPG is independently associated with the presence of PAS and correlates with greater baPWV.OPG shows fair diagnostic performance for identifying PAS and may serve as a vascular risk marker in CKD.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.