High Fetuin-A Level as a Protective Factor to Abdominal Aortic Calcification in Indonesian Regular Hemodialysis Patients

BACKGROUND: Although the prevalence of cardiovascular disease decreases in the general population, this pattern is not followed in hemodialysis patients. Hence cardiovascular events still occur in 50% of cases resulting in hemodialysis patients. One of the risk factors is vascular calcification. The pathogenesis is not yet fully understood, but recent years studies have shown that vascular calcification in chronic kidney disease (CKD) occurs as a result of the interaction of stimulatory and inhibitory factors. One of the inhibitory factors is Fetuin-A. Until now there has been no data on levels of Fetuin-A as a risk factor for abdominal aortic calcification in Indonesia. AIM: To determine the effect of Fetuin-A levels on abdominal aortic calcification in regular hemodialysis patients. METHODS: This study was a cross-sectional study on 76 regular hemodialysis patients at Rasyida Renal Hospital Medan. Fetuin-A level was examined by enzyme-linked immunosorbent assay (ELISA). Assessment of abdominal aortic calcification was done by lateral lumbar X-ray. RESULTS: Most patients (68.4%) had abdominal aortic calcification, in both layers; intima and media (44.7%). Abdominal aortic calcification was associated with Fetuin-A level and age. Multivariate analysis showed that high Fetuin-A levels were significantly associated with abdominal aortic calcification. CONCLUSION: High Fetuin-A level appeared to be a protective factor against abdominal aortic calcification in regular hemodialysis patients in Indonesia.