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Open Access Research

Malnutrition, a new inducer for arterial calcification in hemodialysis patients?

Kun Zhang12, Gang Cheng3, Xue Cai4, Jie Chen5, Ying Jiang6, Tong Wang2, Jingfeng Wang12 and Hui Huang12*

Author Affiliations

1 Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, 510120, China

2 Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120, China

3 Plastic and reconstructive surgery department, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China

4 Department of nephrology, the second hospital of Nanchang, Nanchang, 330003, China

5 Department of Radiation Oncology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, 510120, China

6 School of Mathematics and Computational Science, Sun Yat-sen University, Guangzhou, 510275, China

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Journal of Translational Medicine 2013, 11:66  doi:10.1186/1479-5876-11-66

Published: 18 March 2013

Abstract

Background

Arterial calcification is a significant cardiovascular risk factor in hemodialysis patients. A series of factors are involved in the process of arterial calcification; however, the relationship between malnutrition and arterial calcification is still unclear.

Methods

68 hemodialysis patients were enrolled in this study. Nutrition status was evaluated using modified quantitative subjective global assessment (MQSGA). Related serum biochemical parameters were measured. And the radial artery samples were collected during the arteriovenous fistula surgeries. Hematoxylin/eosin stain was used to observe the arterial structures while Alizarin red stain to observe calcified depositions and classify calcified degree. The expressions of bone morphogenetic protein 2 (BMP2) and matrix Gla protein (MGP) were detected by immunohistochemistry and western blot methods.

Results

66.18% hemodialysis patients were malnutrition. In hemodialysis patients, the calcified depositions were mainly located in the medial layer of the radial arteries and the expressions of BMP2 and MGP were both increased in the calcified areas. The levels of serum albumin were negatively associated with calcification score and the expressions of BMP2 and MGP. While MQSGA score, serum phosphorus and calcium × phosphorus product showed positive relationships with calcification score and the expressions of BMP2 and MGP.

Conclusions

Malnutrition is prevalent in hemodialysis patients and is associated with arterial calcification and the expressions of BMP2 and MGP in calcified radial arteries. Malnutrition may be a new inducer candidate for arterial calcification in hemodialysis patients.

Keywords:
Arterial calcification; Hemodialysis; Malnutrition; Bone morphogenetic protein 2; Matrix Gla protein