Association of Fibroblast Growth Factor-23 Level with Carotid Intima Media Thickness in Hemodialysis Patients

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Kamal Mohammed Okasha
Mabrook Ramadan Alsheekh
Nesreen Kotb
Sherein Alnabawy
Omneya M Darrag
Mohammad Sweilam
Kareem Mohammed Ramadan
Mohammed Hamed Sherif
Mohamed Sabry Aboelnasr


cardiovascular mortality, carotid intima media thickness, fibroblast growth factor-23, hemodialysis


Background: One of most prevalent cause of death in patients on hemodialysis (HD) is cardiovascular disease (CVD). Cardiovascular events in HD patients are significantly predicted by ultrasound measurements of carotid intima media thickness (cIMT). The hypothesis that serum fibroblast growth factor-23 (FGF-23) may be independently correlated with cardiovascular risk factor has been suggested because of the substantial correlation between altered mineral metabolism and increased cardiovascular risk in patients with chronic kidney disease (CKD). This study's objective was to assess the plasma FGF-23 level and its correlation to cIMT in patients with kidney failure on HD.
Methods: 100 participants on regular HD participated in the study. Two groups of patients were created based on cIMT; group 1 consisted of 50 participants with increased cIMT ≥ 1 mm, and group 2 consisted of 50 participants with cIMT below 1 mm. Patients with diabetes mellitus, patients on anticoagulant therapy and those with history of parathyroidectomy were excluded from the study. High resolution B-mode ultrasonography was utilized to evaluate cIMT at the common carotid artery.
Results: The study showed that FGF-23 was significantly greater in patient group with increased cIMT, however it wasn't a reliable indicator of increased cIMT on regression analysis. cIMT was in a strong correlation with duration of dialysis, PTH and phosphorus and in a negative correlation with body mass index. FGF-23 was strongly and positively linked with both age and PTH.
Conclusion: Phosphorous level and duration of dialysis and not FGF-23 were the significant independent predictors for increased cIMT.

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