Serum fibroblast growth factor-23 (FGF-23) levels are independently associated with left ventricular mass and myocardial performance index in maintenance haemodialysis patients

Kırkpantur, Alper; Balci, Mustafa; Gürbüz, Oğuz Alp; Afsar, Barış; Canbakan, Başol; Akdemir, Ramazan; Aylı, Mehmet Deniz

doi:10.1093/ndt/gfq539

Cited by 89 publications

(45 citation statements)

References 52 publications

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“…Since the plasma FGF-23 level is regulated by serum Pi [22,23] and vica versa [24,25], it appears that the plasma log FGF-23 levels should be different between groups. In many studies, it was reported that there was a correlation between serum FGF-23 levels and serum creatinine, phosphate, Ca x P product, and parathormon levels [7,20,26,27]. We also found a positive and signi�icant relationship between log FGF-23 levels and serum phosphate, log PTH , and Ca x P product.…”

Section: Discussionsupporting

confidence: 69%

Relationship of Fibroblast Growth Factor 23 with Left Ventricle Mass Index and Coronary Calcificaton in Chronic Renal Disease

Ünsal

Budak

Koç

et al. 2012

Kidney Blood Press Res

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Background: to evaluate the relationship between FGF23 and changes in biochemical parameters, left ventricle mass index, coronary, aortic and, valve calcifications. Methods: Totally 185 patients with chronic renal disease were included in this prospective, cross-sectional study. The patients were stratified according to GFR levels (mL/min/1.73m²) into 5 groups: ≥60, 45-59, 30-44, 15-29 and <15 (group 1-5 respectively).Biochemical parameters, serum FGF23 levels were measured. Echocardiographic assessments and Coronary artery calcification (CAC) with multidetector computerized tomography (MDCT) were done, left ventricle muscle mass (LVMI) was measured all patients. Results: Left ventricular hypertrophy (LVH), aortic and valve calcification were detected in 27.8%, 25.3% and 12% of patients respectively. CAC was detected in 18 patients. LVMI and FGF23 levels were found to increase proportionally with the severity of renal failure. A significant positive correlation between FGF-23 level and serum phosphate, log_PTH, and CaxP product was found. While a correlation between FGF-23 and valve calcification was detected, no correlation could be detected with LVMI, LVH, coronary and aortic calcification. Conclusion: In CKD, circulating FGF-23 and LVMI levels gradually increase with declining renal function such that by the time patients reach end-stage renal disease. Correlation between log_FGF23and valve calcification was significant, whereas no statistically significant relationship was found between log_FGF23and LVMI, LVH, aortic and coronary artery calcifications.

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Section: Discussionsupporting

confidence: 69%

Relationship of Fibroblast Growth Factor 23 with Left Ventricle Mass Index and Coronary Calcificaton in Chronic Renal Disease

Ünsal

Budak

Koç

et al. 2012

Kidney Blood Press Res

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“…In fact, a strong positive association between FGF-23 serum levels, impaired vasoreactivity atherosclerosis, left ventricular mass index and left ventricular function was seen independently from renal function and mineral status [75,76,77,78,79]. Furthermore, we were able to detect FGF-23 within calcified carotid atheromas derived from patients with preserved renal function, and observed a positive association between the FGF-23 serum concentration and the degree of calcification [80].…”

Section: Ckd-mbd Effects On the Cardiovascular Systemmentioning

confidence: 99%

Cardiovascular Risk and Mineral Bone Disorder in Patients with Chronic Kidney Disease

Staude

Jeske

Schmitz

et al. 2013

Kidney Blood Press Res

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The term chronic kidney disease-mineral bone disorder has been coined recently to highlight that the disturbed mineral and bone metabolism is a major contributor to vascular calcification and finally cardiovascular disease. This syndrome is characterized by clinical, biochemical and/or histological findings, i.e. i) biochemical alterations in the homeostasis of calcium, phosphate and their key player parathyroid hormone (PTH), Fibroblast growth factor-23 (FGF-23), klotho and vitamin-D, ii) the occurrence of vascular and/or soft tissue calcification, and iii) an abnormal bone structure and/or turnover. Apart from the combined and synergistic action of "traditional" and uremia-related risk factors, promoters and inhibitors of calcification have to be considered as well. This review will focus on the disturbed mineral metabolism as the triggering force behind distortion of vascular integrity and cardiovascular malfunction in CKD patients.

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“…Several previous histological studies support the role of FGF23 in vascular calcification 15) ; serum FGF-23 concentrations were significantly associated with the degree of atheroma calcification 16) , and calcium deposition was correlated with FGF23 immunoreactivity in the coronary artery of the explanted heart 17) . Using multidetector computed tomography (MDCT), the potential association between FGF23 and CAC and/or AVC has also been clinically examined [18][19][20] , albeit with inconsistent results. However, the possibility remains that hyperphosphatemia rather than the FGF-23 level is the major factor driving vascular calcification 21) , which may also be indicated by the finding that FGF23 was not associated with arterial calcification and does not promote calcification 22) .…”

Section: Patient Characteristicsmentioning

confidence: 99%

Gender Specific Association between Serum Fibroblast Growth Factor 23/α-Klotho and Coronary Artery and Aortic Valve Calcification

Morita

Takeda

Fujita

et al. 2015

J Atheroscler Thromb

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Aim: Fibroblast growth factor 23 (FGF23) and -Klotho have been recently identified to play a crucial role in calcium/phosphate metabolism. We herein investigated the possible relation between serum FGF23/ -Klotho levels and coronary artery calcification (CAC) and aortic valve calcification (AVC). Methods: Among subjects with diagnosed or suspected coronary artery disease (CAD), CAC and AVC were estimated via the Agatston score of 320-detector computed tomography images, and serum FGF23 and -Klotho levels were measured. Results: In total, 157 subjects were enrolled (75 women and 82 men). We performed logistic regression using CAC as a dependent variable; the highest FGF23 tertile ( 52.5 pg/mL) was significantly positively associated with CAC with an odds ratio of 6.61 versus the lowest FGF23 tertile ( 35.3 pg/mL) in women after the adjustment for potential confounding variables including age, renal function, hypertension, statin use, diuretic use, and calcium/phosphate metabolism related factors. In addition, the highest -Klotho tertile ( 561 pg/mL) was significantly associated with AVC with an odds ratio of 6.31 versus the lowest -Klotho tertile ( 306 pg/mL) in men after adjusting for the same variables. On the other hand, the association between FGF23 and CAC/AVC in men or that between -Klotho and CAC/AVC in women was nonsignificant. Conclusion: Among subjects with diagnosed or suspected CAD, serum FGF23 was positively associated with CAC in women and serum -Klotho was positively associated with AVC in men independent of the confounding variables, including the renal function and calcium/phosphate metabolismrelated factors. J Atheroscler Thromb, 2015; 22: 1338-1346.

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Serum fibroblast growth factor-23 (FGF-23) levels are independently associated with left ventricular mass and myocardial performance index in maintenance haemodialysis patients

Cited by 89 publications

References 52 publications

Relationship of Fibroblast Growth Factor 23 with Left Ventricle Mass Index and Coronary Calcificaton in Chronic Renal Disease

Relationship of Fibroblast Growth Factor 23 with Left Ventricle Mass Index and Coronary Calcificaton in Chronic Renal Disease

Cardiovascular Risk and Mineral Bone Disorder in Patients with Chronic Kidney Disease

Gender Specific Association between Serum Fibroblast Growth Factor 23/α-Klotho and Coronary Artery and Aortic Valve Calcification

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