Abstract: Objective　To explore the relationship between serum runt-related transcription factor 2 (Runx2) mRNA expression and arterial calcification in patients with uremia. Methods　A total of 78 uremic patients who underwent autologous arteriovenous fistula plasty and resection and reconstruction in our hospital were selected as the research objects, and blood vessel tissue, serum samples and clinical data of patients were collected. The calcification score were based on silver nitrate results, the patients were divided into the calcified group (n=23) and the non-calcified group (n=55). The expression level of Runx2 in blood vessel tissue was detected by immunohistochemistry, and the expression level of Runx2 mRNA in serum was detected by real-time fluorescence quantitative method. The changes of clinical indicators were compared between the two groups. The factors affecting vascular calcification of each indicator were analyzed by linear regression, and the predictive ability of serum Runx2 mRNA on vascular calcification was evaluated by ROC curve. Results　The results of silver nitrate staining showed that compared with the non-calcified group, the black deposits were significantly increased in the calcified group. The immunohistochemical results showed that the Runx2 score was significantly increased in the calcified group (P＜0.05). Compared with the non-calcified group, the age, dialysis age, blood phosphorus, iPTH and serum Runx2 mRNA expression levels were significantly increased in the calcified group (P＜0.05), and serum albumin and blood calcium were significantly decreased (P＜0.05). Spearman correlation analysis showed that age, dialysis age, blood phosphorus, iPTH, serum Runx2 mRNA, Runx2 score were positively correlated with calcificationscore, and serum albumin and blood calcium were negatively correlated with calcification score (P＜0.05). The results of multiple linear regression analysis showed that the elevated serum Runx2 mRNA expression levels, long dialysis age and hypocalcemia were independent risk factors for arterial vascular calcification in patients with uremia (P＜0.05). ROC curve analysis showed that the area under the ROC curve (AUC) of serum Runx2 mRNA combined with dialysis age and blood calcium to diagnose vascular calcification was 0.934. Conclusion　Serum Runx2 mRNA expression is an independent risk factor for arterial vascular calcification in uremic patients, and which may be a biomarker for the diagnosis and prediction of arterial vascular calcification in uremic patients.

Key words: uremia, renal dialysis, vascular calcification, core binding factor alpha 1 subunit, runt-related transcription factor 2, blood calcium, dialysis age