The following is a summary of “Alpha 2-Heremans-Schmid glycoprotein gene polymorphism (rs4918) is associated with coronary artery calcification in incident peritoneal dialysis patients,” published in the January 2023 issue of Nephrology by Dai, et al.


The majority of individuals who get peritoneal dialysis (PD) develop coronary artery calcification (CAC), a frequent and serious consequence. The alpha 2-Heremans-Schmid glycoprotein (AHSG) gene encodes fetuin-A, an inhibitor of serum calcification. For a study, researchers sought to investigate the effect of the AHSG gene variant rs4918 in PD patients’ CAC and CAC development.

In the prospective study, incident PD patients at Huashan Hospital Fudan University in China were enrolled and followed up for 2 years between August 2007 and July 2018. Patients had their CAC measured both when they were recruited and two years afterward. Serum fetuin-A levels and the AHSG gene polymorphism rs4918 were assessed initially. The follow-up period saw the collection of demographic information, clinical information, and laboratory information. The link between rs4918 and CAC and CAC progression was investigated using binary logistic regression.

A total of 202 PD patients were enrolled, with a mean age of 54±16 years and a male predominance of 112 (55.4%). The genotype GG was discovered by multivariate logistic regression as an independent risk factor that is associated with CAC (odds ratio [OR] = 2.153; 95% CI: 1.182-3.925; P =.012) and CAC progression (OR = 2.482; CI: 1.422-4.330; P =.001). The rs4918 variations of AHSG affected serum fetuin-A level, with a dose-dependent effect depending on the quantity of the G allele.

In a group of patients undergoing PD, the AHSG gene polymorphism rs4918 alters blood fetuin-A levels and strongly correlates with both CAC and CAC development.

Reference: onlinelibrary.wiley.com/doi/10.1111/nep.14126