Serum Osteoprotegerin Is Associated Independently with Peripheral Arterial Stiffness in Chronic Kidney Disease

Background/Objectives: Patients with chronic kidney disease (CKD) often present with peripheral arterial stiffness (PAS), which is associated with an increased cardiovascular risk. This study assessed the association between circulating osteoprotegerin (OPG), a known mediator of vascular calcification, and PAS, measured as brachial–ankle pulse wave velocity (baPWV), in patients with CKD. Methods: This cross-sectional investigation engaged 200 individuals with non-dialysis CKD. Serum OPG concentrations were measured using a commercial enzyme-linked immunosorbent assay. Participants were classified as having PAS when either left or right baPWV was greater than 18.0 m/s; those with baPWV values of 18.0 m/s or lower were assigned to the control group. Results: Eighty-six patients (43.0%) had PAS. In comparison to controls, PAS patients were older (p < 0.001) and had higher proportions of diabetes mellitus (p = 0.023) and hypertension (p = 0.010); systolic blood pressure was higher (p < 0.001), urine protein-to-creatinine ratio was elevated (p = 0.004), and serum OPG was markedly greater (p < 0.001), whereas estimated glomerular filtration rate was lower (p = 0.003). After full adjustment, OPG levels, in addition to older age and diabetes mellitus, demonstrated an independent association with PAS (odds ratio: 1.008; 95% confidence interval: 1.002–1.015; p = 0.010). The OPG level was positively associated with bilateral baPWV by Spearman’s correlation analysis (p < 0.001). Conclusions: Circulating OPG level showed an independent association with PAS and baPWV in CKD patients not yet on dialysis. Hence, OPG can be a potential marker of vascular risk in this patient population.