Effect Of The FGF-21 And BMP-2 On Vascular Calcification Of Autologous Arteriovenous Fistula In Maintenance Hemodialysis Patients

Objective:To investigate the effects of fibroblast growth factor-21（FGF-21）and bone morphogenetic protein-2（BMP-2）on vascular calcification of autologous arteriovenous fistula（AVF）in maintenance hemodialysis patients.Methods:A total of 20 cases of undergoing internal fistula repair and 20 cases of CKD4-5 primary internal fistula in the nephrology department of the First Affiliated Hospital of Bengbu Medical College in Anhui Province maintenance hemodialysis patients were selected as the observation group,and 20 cases of healthy people matched with age and gender in the health examination center of our hospital were selected as the control group.Within the group to establish autogenous arteriovenous fistula operation to return trim under internal fistula blood vessels（the head of the patients with fistula in the early intravenous tissue,repair the fistula patients of the vein was arterialized venous head）,alizarin red S staining to detect presence of calcification,and calculate the calcification score for calcified stage（severe calcification,mild-to-moderate calcification group,without calcification group）.The basic information,serum biochemical parameters and brachial and ankle pulse wave conduction velocity（ba PWV）of the observation group and the control group were collected.Serum concentrations of FGF-21 and BMP-2 were determined by elisa.Immunohistochemistry was used to detect the expression of FGF-21 and BMP-2 in the vascular wall of internal fistula in the observation group.Results:The serum FGF-21 and BMP-2 levels in observation group were significantly higher than those in control group（P<0.01）.With the aggravation of vascular calcification,the higher the level of FGF-21 and BMP-2 in serum,the stronger the expression of FGF-21 and BMP-2 in the immune tissue of the vascular wall with higher degree of calcification（P<0.01）.Serum FGF-21 level,BMP-2 level,serum phosphorus,creatinine,parathyroid hormone,ba PWV were positively correlated with internal fistula vascular calcification in the observation group（r_s=0.850,0.769,0.718,0.433,0.441,0.457,respectively）（P<0.01）.Conclusion:The level of FGF-21 and BMP-2 are correlated with the vascular calcification of autologous arteriovenous fistula in patients with maintenance hemodialysis,which can be used as the reference for monitoring the vascular calcification of internal fistula.