FGF 23-Klotho Axis And Vascular Calcification In Chronic Hemodialysis Patients

Objectives · To find out the association between FGF23/klotho level and the development of vessel wall calcification in chronic hemodialysis patients.· To measures the FGF23 and Klotho levels in patients on hemodialysis.· To assess the vessel wall condition by radio imaging technique.(CT scan guided)in those patients.Methods This was a hospital based case control study.In our study altogether 174(95 cases and 79 control)subjects were included.There were 49 male(51.6%)and 46 female(49.4%)in case group and there were 43 male(54.4%)and 36 female(45.6%)in control group.A thorough demographic(Age,Sex,Occupation & Marital status)and clinical history(Signs/Symptoms,past medical history)was obtained from each patient.Control patients were also evaluated by a thorough history and physical examination.Baseline data and outcomes were obtained from hospital records.The aim and objectives of this study was clearly explained to the patients and then a written informed consent was produced.Data were processed and analyzed with the help of SPSS(Statistical Package for Social Sciences)version 25 & Microsoft excel 2016.The used statistical method were: Independent simple t test,Spearson rank analysis and multiple regression analysis.Results After collecting with precaution and proper procedure different parameter of blood sample have been measured by the hospital diagnostic services and blood sample results include serum calcium(2.68 ± 0.14),phosphate(1.67 ± 0.18),serum FGF23(150.52 ± 22.12),serum Klotho(284.5 ± 42.2),Hemoglobin(101.7 ± 7.4),serum creatinine(889.9 ± 195.2),PTH(62.37 ± 22.5),Triglyceride(1.62 ± 0.57)total cholesterol(4.6 ± 1.03)and blood glucose(5.4 ± 1.2).On the other hand in control group there were 43 male(54.4%)and 36 female(45.6%)and following parameters were documented-Age(56.35 ± 10.92),serum glucose(4.72 ± 0.61),serum cholesterol(4.01 ± 0.5),Triglyceride(1.28 ± 0.24),Calcium(2.39 ± 0.09),phosphate(1.25 ± 0.15),Hemoglobin(124.95 ± 8.31),serum Klotho(403.67 ± 21.29),and serum FGF23(60.20 ± 6.24).Some important blood test parameters significant for our research study included;serum samples of the patients on maintenance hemodialysis(case group)revealed the levels of serum FGF 23(150.52 ± 22.19,P <0.01),serum Klotho(284.5± 42.16,P <0.01),serum calcium(2.68 ± 0.14),phosphate(1.67 ± 0.18).The analysis results showed significantly negative correlation between FGF 23 and serum Klotho levels on both case and control study group(r =-0.702,P < 0.01),positive correlation of FGF 23 with serum calcium(r= 0.894,P < 0.01),serum phosphate(r= 0.702,P < 0.01),ACI(r= 0.213,P < 0.05).Conclusions · FGF23 has a significant negative correlation with serum Klotho while positive correlation with serum calcium,phosphate,PTH level and Aortic calcification index.· Measuring FGF23 & Klotho can be used as a predictor marker and over all prognosis for vascular calcification in patients on chronic HD.