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Relation of fibroblast growth factor-23 and cardiovascular calcification in end-stage kidney disease patients on

Tarek Zakaria El Baz1, Osama Ahmed Khamis1, Osama Ashry Ahmed Gheith2

  • 1Department of Internal Medicine and Nephrology, Faculty of Medicine, Al Azhar University, Cairo, Egypt.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|January 19, 2017
PubMed

Insights

Elevated fibroblast growth factor 23 (FGF-23) is linked to vascular calcification in end-stage kidney disease (ESKD) patients undergoing hemodialysis (HD). This FGF-23 elevation correlates with aortic and coronary artery calcification, highlighting a significant risk factor.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Cardiovascular disease causes over half of deaths in end-stage kidney disease (ESKD) patients.
  • Elevated fibroblast growth factor 23 (FGF-23) is associated with mortality and peripheral calcification in hemodialysis (HD) patients.
  • Vascular calcification, including aortic and peripheral, is linked to mortality in chronic kidney disease (CKD).

Purpose of the Study:

  • To investigate the relationship between intact FGF-23 and cardiovascular calcification in ESKD patients on regular HD.
  • To assess the prevalence of vascular calcification in this patient group.
  • To explore correlations between FGF-23, calcification, and other risk factors.

Main Methods:

  • Cross-sectional study of 60 clinically stable ESKD patients on regular HD.
  • Evaluation of abdominal aortic calcification via X-ray, with CT scans for coronary artery calcification in affected patients.
  • Assessment of lipid profile, dialysis adequacy, and plasma intact FGF-23 levels.

Main Results:

  • Fifty percent of patients exhibited vascular calcification.
  • Elevated plasma intact FGF-23 was observed in all patients, correlating positively with age, aortic calcification, coronary calcification, lipid profile, left ventricular mass index (LVMI), and inflammatory markers.
  • Significant positive correlations were found between age and FGF-23, and between age, BMI, HD duration, and abdominal aortic calcification score.

Conclusions:

  • Plasma intact FGF-23 is elevated in non-diabetic ESKD patients on HD and correlates significantly with vascular calcification.
  • Vascular calcification is prevalent in this ESKD population, associated with traditional and non-traditional risk factors.
  • FGF-23 may indirectly contribute to vascular calcification through its effects on mineral metabolism and parathyroid hormone.

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