FGF-23 associated with the progression of coronary artery calcification in hemodialysis patients

BMC Nephrol. 2013 Nov 1:14:241. doi: 10.1186/1471-2369-14-241.


Background: Disordered mineral metabolism is implicated in the pathogenesis of vascular calcification in hemodialysis (HD) patients. Fibroblast growth factor 23 (FGF-23) is the main regulator of phosphate metabolism. In this prospective study, we aimed to investigate the association of serum FGF-23 with progression of coronary artery calcification in HD patients.

Methods: Seventy-four HD patients (36 male/38 female, mean age: 52 ± 14 years) were included. Serum FGF-23 levels were measured by ELISA. Coronary artery calcification score (CACS) was measured twice with one year interval. Patients were grouped as progressive (PG) (36 patients-48%) and non-progressive (NPG).

Results: Age, serum phosphorus, baseline and first year CACS were found to be significantly higher in the PG compared to NPG group. Serum FGF-23 levels were significantly higher in PG [155 (80-468) vs 147 (82-234), p = 0.04]. Patients were divided into two groups according to baseline CACS (low group, CACS ≤ 30; high group, CACS > 30). Serum FGF-23 levels were significantly correlated with the progression of CACS (ΔCACS) in the low baseline CACS group (r = 0.51, p = 0.006), but this association was not found in high baseline CACS group (r = 0.11, p = 0.44). In logistic regression analysis for predicting the PG patients; serum FGF-23, phosphorus levels and baseline CACS were retained as significant factors in the model.

Conclusions: Serum FGF-23 was found to be related to progression of CACS independent of serum phosphorus levels. FGF-23 may play a major role in the progression of vascular calcification especially at the early stages of calcification process in HD patients.

Publication types

  • Clinical Trial

MeSH terms

  • Biomarkers / blood
  • Calcinosis / blood*
  • Calcinosis / epidemiology*
  • Causality
  • Comorbidity
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / epidemiology*
  • Disease Progression
  • Female
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Renal Dialysis / statistics & numerical data*
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / rehabilitation*
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Turkey / epidemiology


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