Figurek Andreja, Spasovski Goce, Popovic-Pejicic Snjezana
Department of Nephrology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
Ther Apher Dial. 2018 Feb;22(1):40-48. doi: 10.1111/1744-9987.12592. Epub 2017 Oct 3.
Considering high cardiovascular (CV) risk in chronic kidney disease (CKD), the aim of this cross-sectional study was to assess the association between carotid intima-media thickness (IMT) and fibroblast growth factor (FGF) 23 as important players in CV pathophysiology. Eighty-seven patients with mean estimated glomerular filtration rate 40.1 mL/min per 1.73 m were involved. FGF23 and IMT were elevated from early stages of CKD. Mean IMT value was 1.10 ± 0.20 mm, being significantly elevated starting from early CKD, showing no correlation with FGF23 (r = -0.01, P = -0.91). Unlike the FGF23 level that followed worsening of kidney function, IMT was increasing only in the initial CKD stages, with no further increase from CKD stage 3 on. Although we found no direct association between current use of vitamin D and statin therapy, this may be associated with the sustained reference values of lipid and vitamin D status under treatment that further preclude worsening of IMT in patients with advanced CKD.
鉴于慢性肾脏病(CKD)患者存在较高的心血管(CV)风险,这项横断面研究的目的是评估颈动脉内膜中层厚度(IMT)与成纤维细胞生长因子(FGF)23之间的关联,二者均为CV病理生理学中的重要因素。研究纳入了87例平均估计肾小球滤过率为每分钟40.1 mL/1.73 m²的患者。FGF23和IMT在CKD早期阶段就已升高。平均IMT值为1.10±0.20 mm,从CKD早期开始即显著升高,与FGF23无相关性(r = -0.01,P = -0.91)。与随肾功能恶化而升高的FGF23水平不同,IMT仅在CKD初始阶段升高,从CKD 3期起不再进一步升高。尽管我们发现目前使用维生素D和他汀类药物治疗之间无直接关联,但这可能与治疗期间脂质和维生素D状态的持续参考值有关,这些参考值进一步防止了晚期CKD患者IMT的恶化。