*Purpose: Osteopontin (OPN) is a potent inhibitor of mineralization and is a potent inducible inhibitor of vascular calcification. Studies in patients noted elevated levels of OPN are associated with both the extent of cardiovascular disease and with restenosis. It is interesting to investigate a potential association between serum OPN levels and endothelial function among kidney transplantation (KT) patients.

*Methods: Fasting blood samples were obtained from 84 KT patients. The endothelial function and vascular reactivity index (VRI) was measured using digital thermal monitoring (DTM) test (VENDYS). Serum OPN levels were measured using a commercially available enzyme-linked immunosorbent assays. In this study, VRI < 1.0 was used as the poor vascular reactivity, 1.0 ≤ VRI < 2.0 was used as the intermediate vascular reactivity, and VRI ≥ 2.0 was used as the good vascular reactivity.

*Results: Twelve KT patients (14.3%) were categorized as poor vascular reactivity (VRI < 1.0), 29 KT patients (34.5%) were categorized as intermediate vascular reactivity (1.0 ≤ VRI < 2.0), and 43 KT patients had good vascular reactivity. Increase serum alkaline phosphatase (ALP, P = 0.005) and serum OPN level (P = 0.002) was associated with poor vascular reactivity. Advanced age (r = -0.223, P = 0.041), serum ALP level (r = -0.344, P = 0.017), and serum OPNlevel (r = -0.427, P < 0.001) were negatively correlated with VRI values in KT patients. After multivariable forward stepwise linear regression analysis noted that serum OPN level (β = -0.427, adjusted R² change = 0.173; P < 0.001) was significantly and independently associated with VRI values in KT patients.

*Conclusions: Serum fasting OPN level was negatively associated with VRI values and increased serum OPN level was associated with endothelial dysfunction among KT patients.

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