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Giorgio Coen1, Paolo De Paolis, Paola Ballanti
1Nephrology and Hypertension Unit, Ospedale Israelitico, Rome - Italy. giorgio.coen@gmail.com
Insights
Arterial calcification is common in hemodialysis patients. This study links coronary calcification scores to peripheral artery calcification and explores the roles of FGF-23 and fetuin-A in this process.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Biomarkers
Background:
- Arterial calcification is prevalent in hemodialysis (HD) patients, contributing to mortality.
- Understanding the relationship between different calcification types and biomarkers is crucial.
Purpose of the Study:
- To assess the correlation between coronary artery calcification scores and histological peripheral artery calcification in HD patients.
- To investigate the association of fetuin-A and fibroblast growth factor 23 (FGF-23) with arterial calcifications.
Main Methods:
- Multislice computed tomography (CT) and histological analysis of peripheral arteries in 44 HD patients.
- Humoral assays for fetuin-A and FGF-23.
Main Results:
- Significant correlation found between medial artery calcification and Agatston scores.
- FGF-23 correlated with Agatston scores, suggesting a link to intimal calcification.
- A negative correlation between fetuin-A and FGF-23 was observed.
Conclusions:
- Histological medial calcification correlates with CT-derived Agatston scores, indicating generalized arterial calcification in HD patients.
- FGF-23 may serve as a biomarker for arterial calcification, particularly intimal calcification.
- The interplay between FGF-23, fetuin-A, and vascular calcification warrants further investigation.
Background:
Calcification of arteries is a frequent occurrence in hemodialysis (HD) patients and is linked to mortality. This study was conducted to evaluate the correspondence between coronary calcification scores and calcifications observed histologically in peripheral arteries in HD patients. In addition the association of humoral parameters including fetuin-A and fibroblast growth factor 23 (FGF-23) with arterial calcifications was studied.
Patients And Methods:
HD patients (n=44) were studied with multislice computed tomography (CT) and histological quantification of arterial calcifications in the lower epigastric artery sampled at the time of renal transplant. In addition, humoral assays were performed including fetuin-A and FGF-23.
Results:
There was a significant correlation between medial calcification of the artery and Agatston scores. Natural logarithm (Ln) FGF-23 significantly correlated to Ln Agatston score but not to Ln medial calcification. A significant negative correlation between fetuin-A and Ln FGF-23 was observed, changing to borderline significance after correction for age and Ln HD age. Ln Agatston score in a multiregression analysis was predicted by Ln FGF-23 and age.
Conclusions:
The association found between histologically evaluated calcification of the media of a peripheral artery in HD and the multislice CT Agatston scores is in favor of a generalized arterial calcification, either intimal or of tunica media, when calcium deposits are found in the coronary arteries. The association of FGF-23 with coronary calcification score, already reported, and less so with histological medial calcification is in favor of a link between the protein and intimal more than the medial calcification. FGF-23 may be considered a potential biomarker of arterial calcification in HD patients. The negative association between fetuin-A and FGF-23 may suggest a linkage between these humoral substances, vascular calcifications and mortality. The nature of this linkage requires further studies.
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