Relationship of fibroblast growth factor 23 with left ventricle mass index and coronary calcificaton in chronic renal disease

Kidney Blood Press Res. 2012;36(1):55-64. doi: 10.1159/000339026. Epub 2012 Aug 6.

Abstract

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/1.73 m2) 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, logPTH, 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 logFGF23 and valve calcification was significant, whereas no statistically significant relationship was found between logFGF23 and LVMI, LVH, aortic and coronary artery calcifications.

MeSH terms

  • Adult
  • Aged
  • Aortic Valve / pathology
  • Aortic Valve Stenosis / epidemiology
  • Biomarkers / blood
  • Calcinosis / diagnostic imaging*
  • Calcinosis / epidemiology
  • Calcinosis / physiopathology
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / physiopathology
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / blood*
  • Follow-Up Studies
  • Glomerular Filtration Rate / physiology*
  • Heart Ventricles / pathology*
  • Humans
  • Hypertrophy, Left Ventricular / epidemiology
  • Incidence
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Multivariate Analysis
  • Organ Size
  • Phosphates / blood
  • Prospective Studies
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / pathology*
  • Renal Insufficiency, Chronic / physiopathology

Substances

  • Biomarkers
  • FGF23 protein, human
  • Phosphates
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23

Supplementary concepts

  • Aortic Valve, Calcification of