Abstract: Objective  To observe the clinical features of coronary artery calcification (CAC) in peritoneal dialysis (PD) patients, to find out serological markers for evaluating CAC, and to estimate their application values for the diagnosis of CAC.  Methods  The PD patients treated during March 2022 to March 2023 in the Department of Nephrology, Nanjing Gaochun People's Hospital were recruited for this study. Their clinical data were collected, laboratory examinations were improved, and serum sclerostin, dephospho-uncarboxylated matrix glaprotein (dp-ucMGP) and soluble growth stimulation expressed gene 2 (sST2) were dtermined by ELISA. Spiral CT was used to assess the coronary artery calcification score (CACS). According to CACS, patients were then divided into non-calcified group (CACS=0), mild calcified group (0＜CACS＜100), moderate calcified group (100≤CACS≤400) and severe calcified group (CACS>400). Clinical data and serum indexes were compared among the four groups, and the serological markers were then screened for evaluating CAC.  Results  The prevalence of CAC was 67.96% (70 cases) in a total of 103 PD patients. There were statistical differences in age (F=9.644, P＜0.001), dialysis age (F=8.141, P=0.043), cardiovascular disease rate (F=8.424, P=0.038), total Kt/V (F=3.775, P=0.013), alkaline phosphatase (F=7.909, P=0.048), sclerostin (F=31.513, P＜0.001), dp-ucMGP (F=24.188, P＜0.001), sST2 (F=8.691, P=0.034), and B-type natriuretic peptide precursor (F=13.922, P=0.003) among the four groups. Multivariate logistic regression showed that older age (OR=1.192, 95% CI：1.070～1.327, P=0.001), low Kt/V (OR=0.006, 95% CI：0.000～0.418, P=0.018), higher sclerotin (OR=1.826, 95% CI：1.194～2.792, P=0.006), and higher dp-ucMGP (OR=1.990, 95% CI：1.235～3.207, P=0.005) were the independent risk factors for CAC. ROC curve analysis showed that the areas under the curve of serum sclerostin, dp-ucMGP  and their combined for predicting CAC in PD patients were 0.817 (95% CI: 0.715～0.919, P＜0.001), 0.797 (95% CI：0.705～0.889, P＜0.001), and 0.855 (95% CI：0.776～0.935, P＜0.001) respectively.  Conclusion Serum sclerostin and dp-ucMGP levels are potentially sensitive serological markers for predicting CAC in PD patients, having important value for clinical application.

Key words: Peritoneal dialysis, Coronary artery calcification, Sclerostin, dp-ucMGP