title: High-Flux Hemodialysis Benefits Hemodialysis Patients by Reducing Serum FGF-23 Levels and Reducing Vascular Calcification.
abstract: BACKGROUND
  High- and low-flux hemodialysis (HFHD and LFHD, respectively) are dialysis procedures designed to eliminate blood toxins that accumulate in end-stage renal disease. HFHD may reduce vascular calcification by removing serum fibroblast growth factor 23 (FGF-23). However, whether HFHD is better than LFHD is still under debate. We therefore compared the efficacy of HFHD and LFHD in controlling FGF-23 and vascular calcification.
  
  
  METHODS
  Fifty hemodialysis patients were recruited and randomly treated with either HFHD or LFHD. Fasting venous blood was collected at baseline, six months, and twelve months after the treatment. We then measured levels of FGF-23, calcium, phosphorus, parathyroid hormone, and alkaline phosphatase. Further, abdominal lateral radiographs were taken to calculate aorta abdominalis calcification scores (AACs).
  
  
  RESULTS
  Compared to the LFHD group, FGF-23 and AACs in the HFHD group significantly decreased after 12 months treatment (p=0.049 and p=0.002, respectively). AACs were positively correlated with FGF-23 in all patients (p=0.004), the HFHD group alone (p=0.040), and the LFHD group alone (p=0.037). We also found that older patients, patients with higher blood phosphorus levels, and higher FGF-23 levels had an increased risk of aorta abdominalis calcification (p=0.048, p=0.003, p=0.001, respectively). HFHD was more able to reduce the risk of aorta abdominalis calcification than LFHD (p=0.003).
  
  
  CONCLUSIONS
  FGF-23 is an independent risk factor for the development of vascular calcification. HFHD may benefit hemodialysis patients by reducing serum FGF-23 levels and controlling vascular calcification.
authors.affiliation: Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors.forename: Xiao
authors.initials: X
authors.lastname: Fu
authors.affiliation: Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors.forename: Qin-Qin
authors.initials: QQ
authors.lastname: Cui
authors.affiliation: Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Ning
authors.affiliation: Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors.forename: Shuang-Shuang
authors.initials: SS
authors.lastname: Fu
authors.affiliation: Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood / Q000378:metabolism; D001012:Aorta, Abdominal / Q000473:pathology; D002118:Calcium / Q000097:blood; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005786:Gene Expression Regulation; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011860:Radiography, Abdominal; D012044:Regression Analysis; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000628:therapy; D012307:Risk Factors; D061205:Vascular Calcification / Q000097:blood*
chemical_list: C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D010758:Phosphorus; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D000469:Alkaline Phosphatase; D002118:Calcium