title: FGF-23, vascular calcification, and cardiovascular diseases in chronic hemodialysis patients.
abstract: BACKGROUND
  Chronic hemodialysis (HD) patients have bad prognosis and cardiovascular diseases (CVD) represent their main threatening complication. Fibroblast growth factor (FGF-23) has been associated with all kinds of evil consequences, including cardiovascular morbidity, but some studies demonstrated the contrary. Therefore, it is important to know whether FGF-23 is associated with cardiovascular risk or protection. The purpose of this study was to assess the links between FGF-23 and intimal vascular calcification (VC) and with the presence of CVD in chronic HD patients.
  
  
  METHODS
  This study was carried out on a cohort of randomly selected 88 prevalent HD patients. We recorded demographical, clinical, and biochemical data, including FGF-23. VC was evaluated on carotid ultrasound. CVD were registered.
  
  
  RESULTS
  The mean age was 59.68 ± 14.49 years, HD vintage was 59.61 ± 52.39 months, and 20 patients were diabetic (22.72 %). VC was present in 54 patients (61.4 %) and 25 patients (28.4 %) had CVD. FGF-23 correlated positively with HD vintage (r = 0.37; p < 0.001) and iPTH (r = 0.21; p = 0.048). FGF-23 did not correlate with VC score. Patients with CVD were older (p = 0.006), had lower FGF-23 (p = 0.008), higher VC score (p = 0.009), lower Hb (p = 0.008), albumin (p = 0.003), and creatinine (p = 0.03). Low FGF-23 was identified as a risk factor for CVD.
  
  
  CONCLUSIONS
  We report on a novel association between low FGF23 and CVD in chronic HD patients and a lack of correlation of FGF-23 with VC. FGF-23 could play a role in cardiovascular protection that remains to be confirmed in larger studies.
authors.affiliation: Nephrology Department of Emergency County Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania, dnmoldovan@yahoo.com.
authors.forename: Diana
authors.initials: D
authors.lastname: Moldovan
authors.forename: Ioan
authors.initials: I
authors.lastname: Moldovan
authors.forename: Crina
authors.initials: C
authors.lastname: Rusu
authors.forename: Ina
authors.initials: I
authors.lastname: Kacso
authors.forename: Ioan Mihai
authors.initials: IM
authors.lastname: Patiu
authors.forename: Mirela
authors.initials: M
authors.lastname: Gherman-Caprioara
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color; D061205:Vascular Calcification / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D055815:Young Adult
chemical_list: C000717427:FGF23 protein, human; D006454:Hemoglobins; D012709:Serum Albumin; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D003404:Creatinine
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