Journal Article

Fibroblast growth factor-23 (FGF-23) is independently correlated to aortic calcification in haemodialysis patients

Mohamed M. Nasrallah, Amal R. El-Shehaby, Mona M. Salem, Noha A. Osman, Esam El Sheikh and Usama AA Sharaf El Din

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 25, issue 8, pages 2679-2685
Published in print August 2010 | ISSN: 0931-0509
Published online February 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq089
Fibroblast growth factor-23 (FGF-23) is independently correlated to aortic calcification in haemodialysis patients

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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, R² = 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), R²=0.48; whereas in incident patients, only FGF-23 was associated with ACI (P = 0.007), R² = 0.37.

Conclusions. In haemodialysis patients, FGF-23 and ACI were significantly increased, and FGF-23 was independently associated with aortic calcification.

Keywords: CKD–BMD; FGF-23; haemodialysis; vascular calcification

Journal Article.  3504 words.  Illustrated.

Subjects: Nephrology

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