Fibroblast Gross Factor-23 and Carotid Artery Stiffness in Hemodialysis Patient

Abstract

Background: FGF23 is a free circulating hormone secreted by osteocytes affecting mainly phosphate metabolism as it inhibits its renal tubular reabsorption by suppressing the expression of luminal sodium-phosphate co –transporters (Na Pi). Aim of the Work: Aim of study is to verify the usefulness of FGF23 as a marker for diagnosis of arterial stiffness in CKD patients on regular hemodialysis (3 sessions per week, 4 hours each). Patients and Methods: The present study enrolled 30 living end stage renal disease patients on regular hemodialysis randomly slected from hemodialysis unit at Ain Shams university hospitals after exclusion of patients of known cardiovascular disease or ischemic heart disease,also patients of age below 18 years and above 50 years were excluded as well as patients having arterio venous fistulas on both arms. All patients were subjected to complete medical history taking, including (Age, Sex, Etiology of chronic kidney disease, drugs and duration of dialysis), and detailed clinical examination was done. Results: In this study patients have elevated serum levels of FGF-23 ranging from 100 up to 700 pg/ml. when the normal refrence range is 18-108 pg/ml. Also our study result revealed a statistical significance of negative correlation between FGF-23 and diabetes mellitus duration, serum phosphorous, corrected calcium and estimated glomerular filtration rate as well. The current study shows statistical correlation of positive significance between FGF-23 and hypertension duration where, common carotid artery intima media thickness as well as present plaques in common carotid artery. Moreover there is no statistical significant correlation between FGF-23 and pulse pressure. Conclusion: FGF23 serum levels are markedly elevated in chronic kidney disease CKD and among patients on regular hemodialysis causing arterial stiffness.