{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T22:34:48Z","timestamp":1773873288984,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Portuguese Society of Nephrology (SPN)","award":["Project funding 2016"],"award-info":[{"award-number":["Project funding 2016"]}]},{"name":"FCT - Portuguese Foundation for Science and Technology","award":["Transitional provision DL57\/2016\/CP1361\/CT0006 and project UID\/Multi\/04326\/2019"],"award-info":[{"award-number":["Transitional provision DL57\/2016\/CP1361\/CT0006 and project UID\/Multi\/04326\/2019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Vascular calcification (VC) is one of the strongest predictors of cardiovascular risk in chronic kidney disease (CKD) patients. New diagnostic\/prognostic tools are required for early detection of VC allowing interventional strategies. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor, whose clinical utility is here highlighted. The present study explores, for the first time, correlations between levels of GRP in serum with CKD developmental stage, mineral metabolism markers, VC and pulse pressure (PP), in a cohort of 80 diabetic patients with mild to moderate CKD (stages 2\u20134). Spearman\u2019s correlation analysis revealed a positive association of GRP serum levels with estimated glomerular filtration rate (eGFR) and \u03b1-Klotho, while a negative correlation with phosphate (P), fibroblast growth factor 23 (FGF-23), vascular calcification score (VCS), PP, calcium (x) phosphate (CaxP) and interleukin 6 (IL-6). Serum GRP levels were found to progressively decrease from stage 2 to stage 4 CKD. Multivariate analysis identified low levels of eGFR and GRP, and high levels of FGF-23 associated with both the VCS and PP. These results indicate an association between GRP, renal dysfunction and CKD-mineral and bone disorder. The relationship between low levels of GRP and vascular calcifications suggests a future, potential utility for GRP as an early marker of vascular damage in CKD.<\/jats:p>","DOI":"10.3390\/jcm9030635","type":"journal-article","created":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T07:50:53Z","timestamp":1583135453000},"page":"635","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Gla-Rich Protein (GRP) as an Early and Novel Marker of Vascular Calcification and Kidney Dysfunction in Diabetic Patients with CKD: A Pilot Cross-Sectional Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Ana P.","family":"Silva","sequence":"first","affiliation":[{"name":"Department of Nephrology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"},{"name":"Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"given":"Carla S.B.","family":"Viegas","sequence":"additional","affiliation":[{"name":"Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"},{"name":"GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-8805","authenticated-orcid":false,"given":"Filipa","family":"Mendes","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Ana","family":"Macedo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal"},{"name":"Keypoint Group, 1495-190 Miraflores, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1388-7822","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Guilherme","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Nelson","family":"Tavares","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Carolina","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal"},{"name":"Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"given":"F\u00e1tima","family":"Rato","sequence":"additional","affiliation":[{"name":"Pathology Clinic, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"N\u00e9lio","family":"Santos","sequence":"additional","affiliation":[{"name":"Pathology Clinic, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Mar\u00edlia","family":"Fa\u00edsca","sequence":"additional","affiliation":[{"name":"Pathology Clinic, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0702-4569","authenticated-orcid":false,"given":"Edgar de","family":"Almeida","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade de Lisboa, 1600-190 Lisboa, Portugal"}]},{"given":"Pedro L.","family":"Neves","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"},{"name":"Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5145-4753","authenticated-orcid":false,"given":"Dina C.","family":"Simes","sequence":"additional","affiliation":[{"name":"Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"},{"name":"GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1053\/j.ackd.2015.12.002","article-title":"The economics of late-stage chronic kidney disease","volume":"23","author":"Provenzano","year":"2016","journal-title":"Adv. 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