P4.26 ASSOCIATIONS BETWEEN FGF23-LEVEL AND ARTERIAL DISTENSIBILITY IN CHRONIC KIDNEY DISEASE

Abstract

Vascular calcification and hemodynamical abnormalities lead to reduced arterial elasticity in end stage renal disease. Fibroblast growth factor-23 (FGF23) predicts cardiovascular mortality in advance stages of renal failure possibly indicating more advanced vascular calcification. The relation of FGF23 to arterial stiffness in chronic kidney disease is currently under investigations. The aim of our cross sectional study was to assess the potential associations between FGF23 and arterial distensibility. FGF23 (ELISA), pulse wave velocity (PWV), augmentation index (AI) and central pulse pressure (CPP) (PulsePen), were measured in patients with different stages of renal insufficiency (n=103, 64.8±13.3 years, 50 males, eGFR 40±21 mL/min/1.73m2). Univariate and multiple linear regression models were used for the statistical analysis. According to our results, logFGF23 showed significant relation with serum phosphate, PTH levels and renal function. There were no significant correlations between FGF23 and PWV or CPP. AI, however, correlated negatively with logFGF23 (r= −0.24, p<0.05). By multiple regressions, serum phosphate, logFGF23, systolic blood pressure and heart rate proved to be the individual predictors of AI. (R2=0.31, β=0.31, −0.33, 0.21, −0.27, p<0.05). In the subgroup of patients with <45 mL/min/1.73m2 eGFR, serum phosphate and logFGF23 remained the significant predictors (R2 0.21, β=0.31, −0.39, p<0.05) FGF23 may be a determinant of peripheral arterial elasticity independently of serum phosphate level especially in advanced stages of chronic kidney disease. (Supported by the Hungarian Kidney Foundation and the Hungarian Society of Hypertension)