OSTEOPROTEGERIN AS A RISK FACTOR FOR ARTERIOVENOUS FISTULA FAILURE IN CHRONIC KIDNEY DISEASE THROUGH ARTERIAL CALCIFICATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Certificate Output Instructions

For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".

To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".

Presented the abstract " "
(Abstract co-author(s): )

Back

E-Poster Presentation

During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.

Preparing your E-Poster

Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.

E-Poster Submission Deadline

Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.

E-Poster Format Requirements

PDF file
Layout: Portrait (vertical orientation)
One page only (Dim A4: 210 x 297mm or PPT)
E-Poster can be prepared in PowerPoint (one (1) PowerPoint slide) but must be saved and submitted as PDF file.
File Size: Maximum file size is 2 Megabytes (2 MB)
No hyperlinks, animated images, animations, and slide transitions
Language: English
Include your abstract number
E-posters can include QR codes, tables and photos

E-Poster

https://storage.unitedwebnetwork.com/files/1099/4f3254999153c8c906fe1aa525e912b0.pdf

Abstract Title *

OSTEOPROTEGERIN AS A RISK FACTOR FOR ARTERIOVENOUS FISTULA FAILURE IN CHRONIC KIDNEY DISEASE THROUGH ARTERIAL CALCIFICATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Please follow the instructions below to input your abstract title.

Abstract titles should be brief and reflect the content of the abstract.

The title will not be accepted if it exceeds 25 words.
Type in CAPITAL LETTERS.
Lowercase may be used for abbreviations only, for example, mRNA.

Co-author 1

Nyoman Paramita Ayu paramita_ayu@unud.ac.id Division of Nephrology and Hypertension Department of Internal Medicince, Faculty of Medicine Udayana University – Prof. dr. I G. N. G. Ngoerah General Hospital Denpasar Denpasar Indonesia *

Co-author 2

I Gde Raka Widiana rakawidiana@yahoo.com Division of Nephrology and Hypertension Department of Internal Medicince, Faculty of Medicine Udayana University – Prof. dr. I G. N. G. Ngoerah General Hospital Denpasar Denpasar Indonesia -

Co-author 3

Yenny Kandarini yenny_kandarini@unud.ac.id Division of Nephrology and Hypertension Department of Internal Medicince, Faculty of Medicine Udayana University – Prof. dr. I G. N. G. Ngoerah General Hospital Denpasar Denpasar Indonesia -

Co-author 4

Gede Wira Mahadita wira_mahadita@unud.ac.id Division of Nephrology and Hypertension Department of Internal Medicince, Faculty of Medicine Udayana University – Prof. dr. I G. N. G. Ngoerah General Hospital Denpasar Denpasar Indonesia -

Co-author 5

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Arteriovenous fistula (AVF) serves as the preferred vascular access for hemodialysis. However, AVF failure remains a major complication, often linked to arterial calcification and vascular stiffness. Osteoprotegerin (OPG), a soluble decoy receptor of the tumor necrosis factor (TNF) superfamily, has been implicated in vascular calcification and may contribute to AVF dysfunction. This study aimed to evaluate the association between serum OPG, arterial calcification, and AVF failure in CKD patients undergoing hemodialysis.

Methods

A systematic review and meta-analysis were conducted according to PRISMA guidelines. Comprehensive searches were performed in PubMed and ScienceDirect for studies published up to October 1, 2024, using keywords related to osteoprotegerin, arteriovenous fistula, calcification, and chronic kidney disease. Eligible studies included adult CKD or ESKD patients on hemodialysis that assessed serum OPG levels, arterial or vascular calcification, and AVF outcomes. Data were extracted using standardized forms, and risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled analyses were performed using random-effects models in Review Manager 5, and heterogeneity was evaluated with I² statistics.

Results

Twenty-one studies met inclusion criteria. Eleven studies examined the association between OPG and arterial calcification in CKD patients, consistently showing higher OPG levels among those with calcification. Meta-analysis of four studies demonstrated that the calcification group had significantly elevated serum OPG levels (SMD = 0.72, 95% CI 0.30–1.14, p = 0.0009; I² = 74%). Six studies explored arterial calcification and AVF failure; pooled analysis of four studies revealed that patients with arterial calcification were nearly three times more likely to experience AVF failure (OR = 2.98, 95% CI 1.78–4.99, p < 0.0001; I² = 68%). Only three studies directly assessed OPG and AVF failure. One study reported significantly higher OPG levels in AVF thrombosis (HR = 5.52, p = 0.005), while two studies found no significant associations. The pooled mean difference was not significant (MD = 77.1 [–117.9–272.1]; p = 0.44; I² = 86%).

Conclusion

Elevated serum OPG is associated with arterial calcification, and arterial calcification significantly increases the risk of AVF failure in hemodialysis patients. However, evidence linking OPG directly to AVF failure remains inconsistent and limited by small sample sizes and heterogeneity across studies. Further well-designed prospective and case-control studies are needed to clarify the causal pathway and validate OPG as a predictive biomarker for AVF outcomes in CKD.

Kewords