Title: Study of Fibroblast Growth Factor -23 Levels and its Correlation with Carotid Intima Media Thickness in Chronic Kidney Disease Patients on Hemodialysis
Authors: Dr Pradeep S, Dr Prabal Rajvanshi, Dr Mohd. Javed
DOI: https://dx.doi.org/10.18535/jmscr/v8i3.06
Abstract
Background: CKD is a global public health problem, a leading cause of death and disability worldwide. Patients with CKD is more likely to die of cardiovascular disease than due to end stage renal disease. The cardiovascular mortality in CKD is due to accelerated atherosclerosis and vascular calcification among other factors. Patients with chronic kidney disease (CKD) develop disturbed calcium – phosphate metabolism, the so called mineral bone disease (MBD) which is the primary cause of many adverse effects including cardiovascular diseases.Fibroblast growth factor – 23 (FGF23), a novel hormone secreted primarily by osteoblast is one of the key factors in the development of CKD-MBD.FGF23 level rises early and increases corresponding with the progression of CKD and it acts by increasing the rate of urinary phosphate excretion and suppresses 1,25- dihydroxy vitamin D action. Carotid intima media thickness (CIMT) measurement is considered a valid and reliable surrogate marker for assessment of atherosclerotis. There are conflicting results on association between FGF23 and carotid intima media thickness and paucity of such Indian studies.
Aim: To study the correlation between serum FGF23 levels with carotid intima media thickness in CKD patients on hemodialysis
Materials and Methods: A Cross-sectional Observational Study on a total of 70 patients was conducted in patients with chronic kidney disease on hemodialysisas defined by KDIGO guidelines. Serum intact FGF23 was measured using sandwich ELISA technique. The CIMT was measured with B mode ultrasound using hand held transducer at 7.5 mHz. Correlations between the two were analyzed in detail.
Results: A significant positive correlation was found between FGF23 and CIMT in CKD patients on haemodialysis.FGF23 and CIMT was found to be increased according to the severity of CKD. Both univariate and multivariate regression analysis showed a significant association between FGF23 and CIMT
Conclusion: Serum FGF23 correlate with significantly increased atherosclerotic burden and cardiovascular disease as measured by CIMT in CKD patients on hemodialysis.
