OSTEOPROTEGERIN AND RANKL: A ROLE IN THE DEVELOPMENT OF CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH TERMINAL STAGE OF RENAL FAILURE RECEIVING HEMODIALYSIS

THE AIM: to clarify the possible pathogenic links between the markers of bone mineral metabolism – OPG and RANKL – with markers of cardiovascular diseases characterizing the state of the myocardium and the vascular wall of the aorta in patients undergoing renal replacement therapy.

PATIENTS AND METHODS. 105 patients with C5D CKD were examined: 47 men and 58 women aged 23 to 69 years (mean age -53 ± 2.5 years). The levels of calcium, phosphorus, parathyroid hormone (PTH), osteoprotegerin morphogenetic proteins (OPG) and RANKL (ligand of the receptor activator for the treatment of Kappa B), cardiospecific protein troponin I have been determined. With the help of echocardiography «ALOKA 4000» examined the morphofunctional features of the left ventricle (LV) and aorta. The LV myocardial mass index (LVMI), peak systolic velocity in the aortic arch (Vps) were determined.

RESULTS. Changes in bone mineral metabolism, including an increase in OPG and an increase in the ratio of OPG / RANKL in patients with terminal renal failure, were closely related to an increase in LVMI, a decrease in the LV ejection fraction (LVEF), and an increase in the level of troponin I.

CONCLUSION. In patients with end-stage renal failure, changes in bone mineral metabolism, including a significant increase in the level of OPG and the ratio of OPG / RANKL, are revealed, which indicates a high risk of remodeling processes in the cardiovascular system (CVS), which should be taken into account when choosing cardioprotective therapy. 

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