DOI: 10.36347/sjams.2015.v03i02.043

Pages: 741-750

Fibroblast growth factor 23 (FGF-23) is a potent regulator of serum phosphate level. In CKD, circulating FGF-23 levels gradually increase with declining renal function. Higher FGF-23 level was associated with higher atherosclerosis score. We aimed to study the correlation between FGF-23 and the parameters that have effects on morbidity and mortality in CKD patients and to establish its role as biomarker of cardiovascular disease risk in these patients. This study comprises 80 subjects divided into three groups: group I (40 patients with CKD on regular HD), group II (20 patients with CKD on conservative treatment) group 3 (20 healthy subjects as a control). All patients and controls were subjected to the following: echocardiography, carotid duplex and laboratory investigations including serum calcium, phosphate, parathyroid hormone, alkaline phosphatase, creatinine, blood urea, Iron profile (serum iron, serum ferritin, Tsat, TIBC, FGF23. The laboratory data showed significant increase in creatinine, urea, phosphorus, CaPh product, PTH and FGF-23 with significant decrease in serum calcium and ferritin in group 1 & 2 compared to the controls. There were a statistically significant increase in IVST, PWT, LVM, LVMI and CIMT in group 1 & 2 compared to the controls. FGF-23 showed a positive correlation with creatinine, urea, PTH, CaPh, LVMI & CIMT and negative correlation with ferritin, Hb & HCT. We concluded that elevated FGF-23 level was independently associated with faster progression of CKD, therapy-resistant secondary hyperparathyroidism and increased cardiovascular risk in CKD patients and so, could represent a promising therapeutic target that might improve the fatal prognosis of patients with CKD.