Abstract: Objective To investigate the association of fetuin-A with residual renal function and carotid artery calcification in
patients with chronic kidney disease (CKD). Methods Blood examples were collected form 60 CKD patients in stages CKD3 to
CKD5 (20 patients per stage) for measurement of serum fetuin-A, albumin, calcium, phosphorus and parathyroid hormone,
cholesterol, triglycercide, low-density lipoprotein, and high-density lipoprotein. MDRD equation was used to calculate the
estimated glomerular filtration rate (eGFR), and ELISA was used to detect serum fetuin-A. Color Doppler ultrasound was
performed to measure carotid intima-media thickness (CIMT). Results As the eGFR decreased, serum fetuin-A significantly
decreased in CKD5 stage compared with that in CKD4 stage (P<0.05); compared with that in CKD3 stage, serum fetuin-A level
was significantly lowered in CKD4 stage (P<0.05). Linear regression analysis suggested a significant positive correlation
between fetuin-A and eGFR. The rate of carotid artery calcification was the highest in CKD5 stage. Rank correlation analysis
showed a negative correlation between fetuin-A and cIMT, and logistic regression analysis identified decreased serum
Fetuin-A as a risk factor of carotid artery calcification. Conclusion Serum fetuin-A decreases following the decrease in eGFR,
and decreased serum Fetuin-A level is a risk factor of carotid artery calcification in CKD patients.