Association Of Fibroblast Factor 23 With Calcium-phosphorus Metabolism In Patients With Chronic Kidney Disease

PurposeIn chronic kidney disease, there are almost different levels of calcium and phosphorus metabolism disorders, a large number of evidence suggests that, when the long-term calcium and phosphorus metabolism disorders in CKD, may lead to hyperparathyroidism, and bone mineral metabolic abnormalities, they can still cause the immune dysfunction, metastatic calcification, including lung, heart, heart valves and blood vessels, etc. these pathophysiological changes caused by CKD not only to the many clinical manifestations, but also associated with an increase in mortality in patients with chronic renal failure. Studies concentrated in the regulation of parathyroid hormone-Vitamin D axis of phosphorus, calcium and parathyroid hormone (PTH) in the past. Recently found that bone as an endocrine organ produced by fibroblast growth factor 23 (Fibroblast growth factors 23, FGF23) acting on the renal regulation of calcium and phosphorus metabolism.As a result, bone-kidney hormone axis plays an important different role of the parathyroid hormone-Vitamin D axis regulating phosphorus, vitamin D balance. A large number of foreign research studies have shown that FGF23 is an important indicator of the monitoring of chronic kidney disease, is an earliest indicator in calcium and phosphorus metabolism disorder,is an independent risk factor in poor prognosis for kidney disease.In this paper, ELISA, detection of chronic kidney disease renal function in different circumstances, fibroblast growth factor 23 and the relationship between calcium and phosphorus metabolism. Thus patients with chronic renal calcium and phosphorus metabolism disorder diagnosis and treatment provide a way of thinking.Methods1.Object Select 58 patients with chronic kidney disease non-dialysis in Nephrology in our hospital from September 2009 to February 2010. Aged from 16 to 81 years with a mean age of 50.95 years old, the incidence of 24 cases of chronic glomerulonephritis,6 cases of chronic interstitial nephritis,5 cases of diabetic nephropathy,8 cases of hypertension renal arteriosclerosis,5 cases of polycystic kidney,10 cases of unknown causes. The normal control group is 20 cases of healthy people,10 cases were male and 10 females, with an average age of 47.35 years. Exclusion criteria:obvious infection, liver damage, fractures, cancer, vitamin D-related preparations and unwilling participants.2. Methods(1). Specimen collection:All subjects were fasted 12h, fasting blood drawn, 2500r/min centrifugal 10min, taking the supernatant into the-70℃refrigerator.(2). Target detection:Levels of FGF23 and 1,25(OH)2 D3 were measured by ELISA. Determination kit purchased from Bio-Technology Co., Ltd. Po Tektronix. In strict accordance with the instructions specified steps. Intact parathyroid hormone (iPTH) was detected by the chemical immune chemiluminescence Serum calcium (Ca), phosphorus (P), creatinine (Scr) and blood urea nitrogen (BUN) were assessed by autobiochemistry.3. Statistical analysisStatistical analysis by the SPSS15.0 software. In which measurement data is x±S said that when the difference between the groups is the homogeneity of variance using LSD significant difference method, correlation analysis using Pearson correlation analysis, P<0.05 as statistically significant.Results1. Serum FGF-23 and other indicators of the level changes:With the decline in glomerular filtration rate, levels of serum FGF23, phosphorus and iPTH were increased. Particularly, the control group was quite distinct difference statistically significant in CKD4,5. Levels of phosphorus and FGF23 were higher than the control group in CKD3, but not statistically significant.1,25(OH)2 D3 has dropped in the CKD3, to CKD4,5 the declining significantly, and the control are statistically significant. There were statistically significant between the decline in calcium to CKD5 period with the control group. 2. FGF23 serum levels of related factors Levels of serum FGF23-related factors in CKD3-5:To FGF23, iPTH logarithmic so that a normal distribution in order to logFGF23 as variables, so Pearson correlation analysis showed that, logFGF23 with logiPTH, Cr was positively correlated with GFR,1,25(OH)2 D3 was negatively correlated with the blood P a weak positive correlation.Conclusion1.Along with decreased renal function, serum FGF23, P, iPTH levels increased gradually,1,25 (OH)2 D3 levels began to drop, CKD4-5 achieve greater apparent.2.In the stage of CKD 3-5, level of FGF23 was positively correlated to filtration iPTH, P, Cr; negatively correlated to 1,25(OH)2 D3 and glomerular filtration rate.