The relationship between sclerostin and carotid artery atherosclerosis in patients with stage 3–5 chronic kidney disease

PURPOSE: Sclerostin is an antagonist of the Wnt/β-catenin pathway. We previously reported that sclerostin is closely related to carotid artery atherosclerosis and long-term outcome in hemodialysis patients. The present study investigated the association between sclerostin, renal function, and carotid artery atherosclerosis in non-dialysis patients with stage 3–5 chronic kidney disease (CKD 3–5ND). METHODS: A total of 140 patients with CKD 3–5ND were enrolled in this cross-sectional study. The Chronic Kidney Disease Epidemiology Collaboration equation was used to calculate estimated glomerular filtration rate (eGFR). Atherosclerotic plaques in the carotid artery were detected by B-mode Doppler ultrasound. Blood samples were collected to assess serum sclerostin levels. Unconditional logistic regression analysis was used to identify risk factors for carotid atherosclerotic plaques. RESULTS: The median eGFR was 24.9 ml/min/1.73 m(2) (interquartile range [IQR] 10.0–40.3 ml/min/1.73 m(2)) and median serum sclerostin level was 46.76 pmol/l (IQR 30.18–67.56 pmol/l). Carotid atherosclerotic plaques were detected in 104 subjects (74.3%). There was a negative association between sclerostin level and eGFR (r = − 0.214, p = 0.011). Unconditional logistic regression analysis revealed that sclerostin level was an independent risk factor for the occurrence of carotid plaques, with an odds ratio (95% confidence interval) of 1.026 (1.003, 1.051). CONCLUSION: Serum sclerostin increases with declining renal function in patients with CKD 3–5ND. Sclerostin is an independent risk factor for carotid atherosclerosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11255-020-02495-x) contains supplementary material, which is available to authorized users.