FIBROBLAST GROWTH FACTOR 23 AND CAROTID ARTERY INTIMAL MEDIUM THICKNESS IN CHILDREN WITH CHRONIC KIDNEY DISEASE

Document Type : Original Article

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Abstract

Background: The cause of early-accelerated atherosclerosis development observed in chronic kidney disease (CKD) is not fully understood. The determination of the relationship between the levels of fibroblast growth factor 23 (FGF-23) and carotid artery intimal medium thicknesses (CIMT) and development of endothelial dysfunction lends support to the possibility that FGF-23 plays a role in the development of atherosclerosis in CKD.
Objectives: to assess the circulating FGF23 as a marker of vascular stiffness in children with CKD regardless the etiology and to correlate its level with carotid artery intimal medium thickness as detected by Doppler U/S.
Patients and Methods: This is a prospective case control study was done on forty cases with CKD on conservative treatment (stage II - III and IV) regardless the etiology. Also twenty of apparently healthy children age and sex matched with cases were included as a control group. After complete clinical evaluation of cases and controls including weight, height, body mass index, blood pressure and all body systems, FGF23 was measured and carotid artery intimal medium thicknesses (CIMT) was measured as a marker of atherosclerosis using Doppler U/S.
Results: CIMT measurements and FGF-23 levels were significantly higher in patients than controls. There was positive correlation between FGF23 and CIMT, CKD stage. On the other hand there was negative correlation between FGF23 and GFR.
Conclusion: FGF-23 may be used as a sensitive and non-invasive indicator of subclinical atherosclerosis in patients with chronic kidney disease where our results showed a positive correlation between FGF23 and CIMT.  

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