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The association of fibroblast growth factor 23 with atherosclerosis and arterial stiffness in peritoneal dialysis patients

Melahat Coban, Ayca Inci, Suleyman Dolu, Emre Asilturk, Yildiz Kilar Sozer, Bekir Erol, Hamit Yasar Ellidag.

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Aim: Increased serum fibroblast growth factor-23 (FGF-23) levels are associated with adverse cardiovascular events in chronic kidney disease patients. The aim of our study was to investigate the association of FGF-23 with atherosclerosis and arterial stiffness in patients with peritoneal dialysis (PD).
Material and Methods: This cross-sectional study was performed in 55 (34 (61.8%) male/21 (38.2%) female) PD patients with a mean age of 53.1±11.4 years. The presence of atherosclerosis was determined by carotid artery-intima media thickness (CA-IMT) and the presence of arterial stiffness was determined by brachial-ankle pulse wave velocity (baPWV). Residual renal function was determined by residual glomerular filtration rate (rGFR), renal creatinine clearance (CCr), and residual urine output. FGF-23 and soluble klotho (s-KL) levels were determined by enzyme-linked immunosorbent assay.
Results: CA-IMT (p < 0.001), baPWV (p = 0.003 ), log10 FGF-23 (p < 0.001) were higher and s-KL (p < 0.001) was lower compared with the healthy controls. rGFR (p= 0.007), residual diuresis (p = 0.004) and renal CCr (p = 0.001) were higher in patients with log10 FGF-23 ≤ 2.16 than log10 FGF-23 > 2.16. In multiple regression analysis there was an inverse relationship between log10 FGF-23 and rGFR (p = 0.032), residual diuresis (p = 0.048), renal CCr (p = 0.045). There was no relationship with log10 FGF-23 and CA-IMT, baPWV (p > 0.05).
Conclusion: Increased atherosclerosis and arterial stiffness were detected in PD patients compared to healthy subjects. There was no relationship between FGF-23 and atherosclerosis and arterial stiffness in PD patients.

Key words: Peritoneal dialysis; Fibroblast growth factor-23; Atherosclerosis; Arterial stiffness.

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