title: Fibroblast growth factor 23 is associated with carotid artery calcification in chronic kidney disease patients not undergoing dialysis: a cross-sectional study.
abstract: BACKGROUND
  Fibroblast growth factor 23 (FGF23) is an important hormone in the regulation of phosphate metabolism. It is unclear whether FGF23 is associated with carotid artery calcification (CAAC) in predialysis patients. The present study aimed to clarify the relationship between FGF23 and CAAC in patients with chronic kidney disease (CKD) who were not on dialysis.
  
  
  METHODS
  One-hundred ninety-five predialysis CKD patients were enrolled in this cross-sectional study. CAAC was assessed using multidetector computed tomography, and the prevalence of CAAC was examined. Intact FGF23 was measured in each patient. The risk factors for CAAC were evaluated using a logistic regression model.
  
  
  RESULTS
  We found CAAC in 66% of the patients. The prevalence of CAAC significantly increased across CKD stages: it was 37% in CKD stages 1-2, 58% in stage 3; 75% in stage 4, and 77% in stage 5 (p < 0.01). In multivariate analysis, smoking, diabetes mellitus and log FGF23 were each identified as risk factors for CAAC. The study population was divided in quartiles of FGF23 levels. Compared with the lowest FGF23 quartile, each subsequent quartile had a progressively higher odds ratio (OR) for CAAC, adjusted for confounders (ORs [95% confidence interval] of 2.34 [0.78 to 7.31], 5.28 [1.56 to 19.5], and 13.6 [2.92 to 74.6] for the second, third, and fourth quartiles, respectively.
  
  
  CONCLUSIONS
  The prevalence of CAAC is increased with the decline in the kidney function. FGF23 is independently related to CAAC in patients with CKD who are not on dialysis.
authors: Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Kyushu Medical Center Hospital, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan. mnaka@kyumed.jp
authors: Masaru
authors: M
authors: Nakayama
authors: Yoshiki
authors: Y
authors: Kaizu
authors: Masaharu
authors: M
authors: Nagata
authors: Yoriko
authors: Y
authors: Ura
authors: Hirofumi
authors: H
authors: Ikeda
authors: Sho
authors: S
authors: Shimamoto
authors: Kazuyoshi
authors: K
authors: Kuma
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D002340:Carotid Artery Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003956:Dialysis / Q000706:statistics & numerical data; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000175:diagnosis / Q000534:rehabilitation*; D018570:Risk Assessment
chemical_list: C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23