Minfang Zhang1, Jiayi Yan1, Mingli Zhu1, Zhaohui Ni2. 1. Renal Division, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. 2. Renal Division, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China prof_nizh@126.com.
Abstract
OBJECTIVE: To investigate the relationship of fibroblast growth factor-23 (FGF23) to coronary calcification and prognosis in patients with chronic kidney disease (CKD) stages 3-5D. METHOD: We determined serum levels of intact FGF23 in 150 patients with CKD stages 3-5D, using an enzyme-linked immunosorbent assay (ELISA). The coronary calcification was detected with multi-slice CT, and its relationship to FGF23 was analyzed. These patients were followed up over a period of 35±3 months. RESULT: Serum FGF23 levels of patients with CKD stages 3-5D were significantly higher than those of the healthy control group (p<0.01). There was a significant positive correlation between serum FGF23 levels and coronary calcification score (CaS) (r=0.177, p<0.05). Age, dialysis vintage, and FGF23 levels were independent risk factors for coronary calcification in patients with CKD stages 3-5D. Receiver-operating characteristic (ROC) curves showed that the sensitivity and specificity of FGF23 were 62.5% and 75.9%, respectively, for diagnosing coronary calcification, with an area of 0.705 under the curve (p<0.01). Kaplan-Meier analysis revealed that survival rates were significantly better in patients with lower FGF23 levels (p<0.05). In Cox regression analysis, FGF23 levels and severe coronary calcification (CaS>400) were independent risk factors for all-cause mortality. CONCLUSION: Serum FGF23 level in patients with CKD stages 3-5D was significantly higher than in the healthy controls. These increased FGF23 levels are likely associated with coronary calcification and poor prognosis.
OBJECTIVE: To investigate the relationship of fibroblast growth factor-23 (FGF23) to coronary calcification and prognosis in patients with chronic kidney disease (CKD) stages 3-5D. METHOD: We determined serum levels of intact FGF23 in 150 patients with CKD stages 3-5D, using an enzyme-linked immunosorbent assay (ELISA). The coronary calcification was detected with multi-slice CT, and its relationship to FGF23 was analyzed. These patients were followed up over a period of 35±3 months. RESULT: Serum FGF23 levels of patients with CKD stages 3-5D were significantly higher than those of the healthy control group (p<0.01). There was a significant positive correlation between serum FGF23 levels and coronary calcification score (CaS) (r=0.177, p<0.05). Age, dialysis vintage, and FGF23 levels were independent risk factors for coronary calcification in patients with CKD stages 3-5D. Receiver-operating characteristic (ROC) curves showed that the sensitivity and specificity of FGF23 were 62.5% and 75.9%, respectively, for diagnosing coronary calcification, with an area of 0.705 under the curve (p<0.01). Kaplan-Meier analysis revealed that survival rates were significantly better in patients with lower FGF23 levels (p<0.05). In Cox regression analysis, FGF23 levels and severe coronary calcification (CaS>400) were independent risk factors for all-cause mortality. CONCLUSION: Serum FGF23 level in patients with CKD stages 3-5D was significantly higher than in the healthy controls. These increased FGF23 levels are likely associated with coronary calcification and poor prognosis.
Authors: Barry I Freedman; Jasmin Divers; Gregory B Russell; Nicholette D Palmer; Donald W Bowden; J Jeffrey Carr; Lynne E Wagenknecht; R Caresse Hightower; Jianzhao Xu; Susan Carrie Smith; Carl D Langefeld; Keith A Hruska; Thomas C Register Journal: Am J Nephrol Date: 2015-12-23 Impact factor: 3.754
Authors: Ana P Silva; Carla S B Viegas; Patrícia Guilherme; Nelson Tavares; Carolina Dias; Fátima Rato; Nélio Santos; Marília Faísca; Edgar de Almeida; Pedro L Neves; Dina C Simes Journal: Diagnostics (Basel) Date: 2022-02-15