Abstract: Objective To analyze the serum osteosclerosis protein (SOST) and osteopontin (OPN) levels and their correlation with vascular calcification in maintenance hemodialysis (MHD) patients. Methods
A total of 200 patients who received MHD and follow-up study in the Nephrology Departments of the three
hospitals during June 2017 to September 2020 were recruited as the research subjects. Serum SOST and OPN
were assayed before the first hemodialysis. The presence of vascular calcification during follow-up period was
recorded. Their baseline data and serum SOST and OPN levels were compared, and the correlation between
serum SOST and OPN levels and vascular calcification was evaluated. Results Among the 200 MHD patients, 64 cases had vascular calcification with the incidence of 32% (64/200). Serum phosphorus, calcium and
OPN were higher while serum SOST was lower in the calcification group as compared with those in the noncalcification group (t=4.315, 5.556, 8.611 and 6.208 respectively, P<0.001). Multivariate logistic regression
showed that serum phosphorus, calcium, SOST and OPN levels correlated with vascular calcification in the
MHD patients (OR=8.590, 5.078, 0.489 and 1.062 respectively; 95% CI 2.752～26.815, 2.086～12.362,
0.352～0.680 and 1.039～1.085 respectively; P<0.001). ROC curve showed that the AUC values of serum
SOST, OPN, and their combination in predicting vascular calcification were all >0.70; the decision curve
showed that in the range of high- risk threshold of 0.16- 0.84, the prediction model using combined serum
SOST and OPN levels was better than that using one of the serum levels in assessing the net benefit rate of
vascular calcification in MHD patients. Conclusion Serum SOST and OPN levels were abnormal in MHD patients with vascular calcification. They were closely related to vascular calcification.

Key words: Chronic renal failure, Maintenance hemodialysis, Osteosclerosis protein, Osteopontin, Vascular calcification