ROLE OF SERUM FETUIN-A PROTEIN AS INDICATOR OF CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH CHRONIC RENAL FAILURE ON HEMODIALYSIS

Background: Chronic kidney disease (CKD) is a progressive condition leading to end-stage renal disease (ESRD), in which hemodialysis remains the most widely used therapeutic modality. Cardiovascular disease is a leading cause of morbidity and mortality in CKD and ESRD patients. Fetuin-A, a hepatic glycoprotein, has been implicated in vascular calcification, bone metabolism regulation, and insulin resistance. Reduced serum Fetuin-A levels have been associated with vascular calcification and cardiovascular complications in patients with metabolic and renal disorders. Aim: To evaluate serum Fetuin-A as a potential early indicator of cardiovascular risk in patients with chronic renal failure undergoing hemodialysis. Patients and Methods: This prospective, hospital-based study was conducted at Al-Kadhimiya Teaching Hospital between April and August 2021. Eighty participants were enrolled and divided into three groups: Group I (25 patients on hemodialysis ≥3 years), Group II (25 patients on hemodialysis <3 years), and Group III (30 apparently healthy controls). Serum Fetuin-A, total cholesterol, blood urea, and serum creatinine were measured in all participants. Blood pressure and clinical variables were also assessed. Results: Blood pressure was significantly lower in patients with ≥3 years on dialysis compared to those with <3 years (p < 0.01). Fetuin-A levels were markedly reduced in long-term dialysis patients. Serum Fetuin-A showed negative correlations with age, dialysis duration, systolic and diastolic blood pressure, blood urea, creatinine, and cholesterol. Conclusion: Serum Fetuin-A levels are significantly decreased in hemodialysis patients, particularly with longer dialysis duration, and may serve as an early biomarker for cardiovascular risk in this population.