Volume 88, Issue 6, Pages (December 2015)

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Volume 88, Issue 6, Pages 1356-1364 (December 2015) Increased circulating sclerostin levels in end-stage renal disease predict biopsy-verified vascular medial calcification and coronary artery calcification Abdul Rashid Qureshi, Hannes Olauson, Anna Witasp, Mathias Haarhaus, Vincent Brandenburg, Annika Wernerson, Bengt Lindholm, Magnus Söderberg, Lars Wennberg, Louise Nordfors, Jonaz Ripsweden, Peter Barany, Peter Stenvinkel Kidney International Volume 88, Issue 6, Pages 1356-1364 (December 2015) DOI: 10.1038/ki.2015.194 Copyright © 2015 International Society of Nephrology Terms and Conditions

Figure 1 Sclerostin levels in relation to cardiac computed tomography (CT) score and calcification score. Serum concentrations of sclerostin in 65 patients with Agatston coronary artery calcification (CAC) score (by CT of the heart) of <100AU vs. >100AU (top). At the bottom is serum concentrations of sclerostin in 89 end-stage renal disease (ESRD) patients with none or minimal (n=52) versus moderate or extensive (n=37) histological signs of medial vascular calcification in the epigastric artery. Kidney International 2015 88, 1356-1364DOI: (10.1038/ki.2015.194) Copyright © 2015 International Society of Nephrology Terms and Conditions

Figure 2 Relation of coronary artery calcification (CAC) score and calcification score. Total Agatston CAC score by computed tomography (CT) of the heart (n=65) related to the degree of medial vascular calcification (0–3) scored by a pathologist. Kidney International 2015 88, 1356-1364DOI: (10.1038/ki.2015.194) Copyright © 2015 International Society of Nephrology Terms and Conditions

Figure 3 Receiver operating characteristic (ROC) curves for prediction of vascular calcification. ROCs for prediction of vascular calcification (score 2+3) in the arteria epigastrica by sclerostin (area under the curve (AUC) 0.68; P=0.01), Agatston coronary artery calcification (CAC) score (AUC 0.77; P=0.0001; n=65), insulin growth factor-1 (IGF-1) (AUC 0.64; P=0.04), and tumor necrosis factor (TNF) (AUC 0.63; P=0.02). Kidney International 2015 88, 1356-1364DOI: (10.1038/ki.2015.194) Copyright © 2015 International Society of Nephrology Terms and Conditions

Figure 4 Histological pictures of the four degrees of medial calcification. Histological pictures (von Kossa staining) representing four categories of the degree of medial vascular calcification in inferior epigastric artery from a total of 89 end-stage renal disease (ESRD) patients in whom biopsies were scored by a pathologist (AW) as having no (score=0; n=16), minimal (score=1; n=36), moderate (score=2; n=24), or extensive (score=3; n=13) signs of medial vascular calcification. Kidney International 2015 88, 1356-1364DOI: (10.1038/ki.2015.194) Copyright © 2015 International Society of Nephrology Terms and Conditions