El Baz Tarek Zakaria, Khamis Osama Ahmed, Ahmed Gheith Osama Ashry, Abd Ellateif Salama Saad, Abdallah Abdallah Mahmoud, Abd El Aal Hussein Chahine
Department of Internal Medicine and Nephrology, Faculty of Medicine, Al Azhar University, Cairo, Egypt.
Department of Nephrology and Internal Medicine, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Saudi J Kidney Dis Transpl. 2017 Jan-Feb;28(1):51-60. doi: 10.4103/1319-2442.198127.
More than half of deaths in end-stage kidney disease (ESKD) patients are due to cardiovascular disease. Elevated fibroblast growth factor 23 (FGF-23) was found to be associated with mortality in hemodialysis (HD) patients and correlates with peripheral calcification. Aortic calcification is associated with coronary artery calcification. Both aortic and peripheral vascular calcifications were associated with mortality in chronic kidney disease. We aimed to investigate the relation between intact FGF-23 and cardiovascular calcification in patients with ESKD who were maintained on regular HD. Sixty clinically stable ESKD patients on regular HD were enrolled into this cross-sectional study. They were evaluated by basal abdominal X-ray. They were divided into two groups: (Group A, n = 30), patients with abdominal aortic calcification who underwent multislice computerized tomography scan to measure coronary artery calcification score; and (Group B, n = 30), patients without abdominal aortic calcification. All of them were evaluated by lipid profile and dialysis adequacy parameters. Fifty percent of patients had vascular calcification. We found a significant positive correlation between age and intact FGF-23; significant positive correlations between age, body mass index, duration of HD, and abdominal aortic calcification score. FGF-23 of all patients was elevated and had significant positive correlation with aortic and coronary calcifications in addition to lipid profile, left ventricular mass index (LVMI), and inflammatory markers. Plasma intact FGF-23 was elevated in nondiabetic ESKD patients, and vascular calcification was prevalent in such group of patients with many traditional and nontraditional risk factors. Possibly through its disturbing effects on minerals and parathyroid hormone, FGF-23 might indirectly affect vascular calcification. LVMI was higher in patients with vascular calcification and correlated positively with it.
终末期肾病（ESKD）患者中超过一半的死亡是由心血管疾病所致。研究发现，成纤维细胞生长因子23（FGF - 23）升高与血液透析（HD）患者的死亡率相关，且与外周钙化有关。主动脉钙化与冠状动脉钙化相关。主动脉和外周血管钙化均与慢性肾病患者的死亡率相关。我们旨在研究维持规律血液透析的ESKD患者中完整FGF - 23与心血管钙化之间的关系。60例临床稳定的规律血液透析ESKD患者被纳入这项横断面研究。他们接受了腹部基础X线检查。他们被分为两组：（A组，n = 30），腹主动脉钙化患者，接受多层计算机断层扫描以测量冠状动脉钙化评分；以及（B组，n = 30），无腹主动脉钙化的患者。所有患者均接受血脂谱和透析充分性参数评估。50%的患者存在血管钙化。我们发现年龄与完整FGF - 23之间存在显著正相关；年龄、体重指数、血液透析时长与腹主动脉钙化评分之间存在显著正相关。所有患者的FGF - 23均升高，除血脂谱、左心室质量指数（LVMI）和炎症标志物外，还与主动脉和冠状动脉钙化存在显著正相关。非糖尿病ESKD患者血浆完整FGF - 23升高，且在这类具有多种传统和非传统危险因素的患者中血管钙化普遍存在。FGF - 23可能通过其对矿物质和甲状旁腺激素的干扰作用间接影响血管钙化。血管钙化患者的LVMI较高，且与之呈正相关。
