Serum of HD patients contains FMC. Physical characteristics of fetuin-A from patients who were on HD considerably differ from those of normal control subjects. Serum is processed as described in Figure 1. (A) Centrifugation at 16,000 × g generates pellets from HD patients' serum (n = 4) but not from normal control subjects (n = 4). Separating constituent proteins by SDS-PAGE followed by CBB staining reveals 250-, 78-, 68-, 53-, 50-, 40-, 26-, and 25-kD proteins in the pellet from the HD patients. Proteins of 78, 68, 40, 26, and 25 kD are also observed in the pellet fraction from normal control subjects. Each protein is identified by MALDI-TOF/MS. (B) Concentrations of fetuin-A in serum and in 16,000 × g supernatant are measured by ELISA (Epitope Diagnostic). Although fetuin-A levels in serum and supernatant are comparable in normal control subjects (n = 11), that in supernatant from HD patients (n = 13) declines (Wilcoxon signed-ranks test). (C) Pellet from HD patients' serum contains more calcium. Normal control subjects, n = 11; HD patients, n = 13 (P < 0.001, nonpaired t test).