The relationship between the concentration of fibroblast growth factor-23 and central hemodynamics in patients with chronic kidney disease
1) Kyrgyz State Medical Academy named after I.K. Akhunbaeva, Bishkek, Kyrgyzstan;
2) Kyrgyz-Russian Slavic University, Bishkek, Kyrgyzstan
Aim of the study: examine the relationship between the concentration of fibroblast growth factor-23 and central hemodynamics in patients with chronic kidney disease (CKD).
Material and methods. A total of 78 patients were examined, including 45 women and 33 men. The average age of the examined patients is 55 years old (minimum 23, maximum 84). All patients underwent a comprehensive clinical and laboratory examination. The parameters of central hemodynamics [systolic blood pressure (SBP, mm Hg), diastolic blood pressure (DBP, mm Hg) and central systolic pressure (blood pressure, mm Hg) were investigated]. Fibroblast growth factor- 23 (FGF-23) (pmol/L) concentrations were determined, phosphorus (mmol/L), C-reactive protein (CRP, IU/L) and creatinine (μmol/L) of blood plasma. To calculate the glomerular filtration rate (GFR, ml/min), the formula CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) 2011 was used. According to the KDIGO recommendations (Kidney Disease: Improving Global Outcomes) of 2002, the diagnosis of CKD was established on the basis of changes in urinary sediment or a decrease in estimated GFR (<60 ml/min), an increase in blood plasma creatinine for more than three months.
Results. The mean age, body mass index, and central and systolic blood pressure (BP) values were significantly higher in patients with stage 4 CKD. Persons with a high content of C-reactive protein were significantly more often detected in stages 3b and 5 of CKD. The level of phosphatemia was significantly higher among patients with stages 4 and 5 of CKD. Median and interquartile plasma FGF-23 concentrations were significantly high at stages 3a, 4, and 5 of CKD. The existence of a close relationship between the content of FGF-23 and the level of central and systolic blood pressure, the concentration of phosphorus and creatinine. An inverse relationship was obtained between a decrease in glomerular filtration rate and an increase in the concentration of FGF-23.
Conclusions. In CKD patients, plasma FGF-23 concentration begins to increase even at the pre-dialysis stage. At the same time, high levels of FGF-23 blood plasma is recorded at the 4th stage of CKD and is associated with an increase in central and systolic blood pressure, body mass index, including hyperphosphatemia.
About the Autors
Ilkhom T. Murkamilov – PhD in Medical Sciences, Nephrologist, Deputy Associate Professor at the Department of Faculty Therapy I.K. Akhunbaev KSMA, Kyrgyz-Russian Slavic University; Bishkek, Kyrgyzstan. E-mail: firstname.lastname@example.org, ORCID: 0000-0001-8513-9279