Osteoprotegerin as a predictor of renal and cardiovascular outcomes in renal transplant recipients: follow-up data from the ALERT study.
Svensson M, Dahle DO, et al.Nephrology Dialysis Transplantation, 27(6):2571-5, 2012.
Aims
To examine the association between Osteoprotegerin (OPG) levels, renal outcomes, cardiovascular morbidity and all-cause mortality in a large cohort of renal transplant recipients.
Interventions
Fluvastatin versus placebo.
Participants
1889 renal transplant recipients who were entered into the ALERT trial with available osteoprotegerin at baseline.
Outcomes
Incidence of major adverse cardiovascular events defined as non-fatal myocardial infarction, cardiac death or coronary intervention procedure; incidence rate of renal events defined as time to graft failure or doubling of serum creatinine; all-cause mortality. Covariates for risk factor analysis included age, gender, treatment group, pulse pressure, diabetes, smoking status, total time in renal replacement therapy, creatinine, proteinuria, coronary heart disease, low-density lipoprotein cholesterol, and osteoprotegerin level.
Follow-up
Average 6.7 years
CET Conclusions
In nearly 2000 renal transplant recipients who had been entered into the ALERT trial comparing fluvastatin with placebo, elevated OPG was found to be independently associated with poorer renal function, cardiovascular events and mortality.
Data analysis
Strict intention-to-treat analysis
Quality notes
This is a post hoc analysis of a previous publication of the same RCT: Holdaas H, Fellstrom B, Jardine AG et al. Effect of fluvastatin on cardiac outcomes in renal transplant recipients: a multicentre, randomised, placebo-controlled trial. Lancet 2003; 361: 2024–2031. The methodological quality assessment was based on the previous paper.
Trial registration
Not reported