Serum Osteoprotegerin: Can It Predict Chronic Kidney Disease Among Hypertensives?

Background: Hypertension plays a dual role in chronic kidney disease (CKD), acting both as a precipitating factor and as a consequence of declining renal function. Early renal impairment in hypertensive individuals is often clinically silent, and conventional markers may fail to detect subtle changes. Osteoprotegerin (OPG), a cytokine involved in vascular biology and calcification, has gained attention as a potential indicator of renal and cardiovascular injury. Objectives: To evaluate the association between serum osteoprotegerin levels and renal dysfunction in hypertensive patients, and to assess whether elevated OPG can serve as an early predictor of chronic kidney disease in this population. Methods: A hospital-based case–control study was carried out at Government Mohan Kumaramangalam Medical College Hospital, Salem, from December 2018 to November 2019. Sixty-five hypertensive patients were included as cases, and 35 patients with CKD stages 1–3 served as controls. Renal function was assessed using estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI equation. Serum OPG and routine biochemical parameters were measured, and statistical analyses were performed to evaluate correlations between OPG and indices of renal function. Results: Mean serum OPG levels were significantly lower in hypertensive patients compared to those with CKD (0.73 ± 1.01 ng/ml vs. 3.63 ± 1.99 ng/ml; p = 0.0001). Patients with CKD had higher serum creatinine levels and lower eGFR values. A strong inverse association between OPG and eGFR was observed in both groups, along with a positive correlation between OPG and serum creatinine. Serum OPG also showed significant associations with body mass index and adverse lipid parameters, suggesting a link with both renal dysfunction and cardiovascular risk. Conclusion: Serum osteoprotegerin levels rise in parallel with deterioration of renal function and are closely related to established markers of kidney impairment in hypertensive individuals. These findings support the potential role of OPG as an early biomarker for renal involvement and cardiovascular risk stratification in patients with hypertension.