Background: Vascular calcification (VC) is a common health problem in patients with diabetic nephropathy (DN). Early recognition of vascular calcification has a great effect on the outcome.
Objective: We aimed to assess the efficacy of serum osteopontin (OPN) in the early prediction of VC in patients with diabetic nephropathy.
 Patients and Methods: A total of 70 patients with type 2 diabetes mellitus were divided into equal two groups. Group (A): included 35 patients with diabetic nephropathy with chronic kidney disease (CKD) stage I-IV and group (B): included 35 patients with DN with CKD stage V on hemodialysis. Another 30 healthy subjects were recruited as a control group. Carotid Doppler and echocardiography were done in patients' groups only while serum OPN was measured in all groups.
Results: Osteopontin was found to be higher in group B in comparison to other groups and also higher in group A in comparison control group. A total of 31 (44.3%) patients had VC. Patients with VC had higher OPN in comparison to those without VC. Predictors for VC in patients with CKD were OPN, intima thickness and CKD stage V. OPN at cutoff point > 144 ng/ml had 93% overall accuracy for the prediction of VC in patients with CKD, and the area under the curve was 0.966.
Conclusion: We concluded that (1) OPN level was significantly higher in hemodialysis patients with diabetic nephropathy stages V than those diabetic patients with chronic kidney disease stage I-IV. (2) OPN level was significantly higher in patients with vascular calcification than in those without. So, OPN can be used as an early marker for the detection of vascular calcification.