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Published on: June 2, 2022
Fibroblast growth factor-23 (FGF-23) is independently correlated to aortic calcification in haemodialysis patients
Mohamed M Nasrallah1, Amal R El-Shehaby, Mona M Salem
1Department of Nephrology, School of Medicine, Kasr El-Aini School of Medicine, Cairo University, Cairo, Egypt.
Insights
Fibroblast growth factor-23 (FGF-23) and aortic calcification index (ACI) are elevated in haemodialysis patients. Higher FGF-23 levels are independently associated with increased aortic calcification in these patients.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Biochemistry
Background:
- Vascular calcification poses significant risks for chronic kidney disease (CKD) patients.
- The exact mechanisms driving vascular calcification, particularly aortic calcification, remain unclear.
- Fibroblast growth factor-23 (FGF-23) plays a role in mineral metabolism, potentially influencing vascular calcification.
Purpose of the Study:
- To investigate the association between FGF-23 and aortic calcification in patients undergoing haemodialysis.
- To clarify the relationship between FGF-23 and aortic calcification, addressing conflicting data on peripheral calcification.
Main Methods:
- A cohort of 65 haemodialysis patients and 15 controls were analyzed.
- Exclusion criteria included diabetes, oral anticoagulation, and parathyroidectomy.
- Intact FGF-23, parathormone, lipids, calcium, and phosphorus were measured. Aortic calcification index (ACI) was assessed using non-contrast computed tomography (CT) of the abdominal aorta.
Main Results:
- Haemodialysis patients exhibited significantly higher FGF-23 levels and ACI compared to controls.
- FGF-23 and systolic blood pressure were independently associated with ACI in the overall haemodialysis group.
- In subgroup analyses, FGF-23, systolic blood pressure, and age were linked to ACI in prevalent patients, while only FGF-23 was associated in incident patients.
Conclusions:
- Haemodialysis patients demonstrate elevated levels of both FGF-23 and aortic calcification.
- FGF-23 is an independent predictor of aortic calcification in patients on haemodialysis.
Background:
Vascular calcification has detrimental consequences on chronic kidney disease (CKD) patients, yet its pathogenesis is not fully understood. Fibroblast growth factor-23 (FGF-23) is involved in the regulation of mineral metabolism which may in turn affect vascular calcification. Data on the relationship between FGF-23 and peripheral vascular calcification, using conventional radiographs, are conflicting, and less is known about its relation to aortic calcification. We conducted this study to investigate the relationship between FGF-23 and aortic calcification in a standard haemodialysis setting.
Methods:
The study included 65 haemodialysis patients (46 prevalent and 19 incident) on a three times 4-h dialysis schedule as well as 15 controls. Those with diabetes, oral anticoagulation or parathyroidectomy were excluded. Intact FGF-23, parathormone, lipids, calcium and phosphorus were measured. Aortic calcification index (ACI) was assessed by a non-contrast computerized tomography (CT) of the abdominal aorta.
Results:
FGF-23 levels were higher among haemodialysis patients (4681.3 +/- 3906.1 pg/mL) compared to controls (98.2 +/- 51.9 pg/mL), P = 0.005. ACI was higher in haemodialysis patients (14.1 +/- 12) than controls (3.2 +/- 3.6), P = 0.009. FGF-23 (P < 0.0001) and systolic blood pressure (BP) (P < 0.0001) were independently related to ACI in stepwise multiple regression analysis of pooled analysis of haemodialysis patients, R(2) = 0.476; in subgroup analysis, the independent factors relating to ACI among prevalent dialysis patients were systolic BP (P < 0.0001), FGF-23 (P = 0.002) and age (P = 0.012), R(2)=0.48; whereas in incident patients, only FGF-23 was associated with ACI (P = 0.007), R(2) = 0.37.
Conclusions:
In haemodialysis patients, FGF-23 and ACI were significantly increased, and FGF-23 was independently associated with aortic calcification.
