Factors of vascular calcification in patients with type 2 diabetes mellitus on long-term dialysis

Abstract

Purpose Defining vascular calcification markers in patients on long-term hemodialysis (LTH) with type 2 diabetes mellitus (type 2 diabetes) and without type 2 diabetes.
 Materials and methods. The study was conducted in 82 patients with chronic kidney disease (CKD) (51 men, 31 women) on LTH, of which 25 patients (10 men, 15 women) had type 2 diabetes and 57 people (33 men, 24 women) had no diabetes. All patients underwent evaluation of calcium-phosphate metabolism, control of intact PTH (iPTH), inorganic phosphorus, and total calcium. All patients were tested for the level of fibroblast growth factor-23 (FGF-23) in blood serum using a multi-enzyme immunoassay kit, and the correlation between these parameters and the presence of vascular calcification was evaluated.
 Results. A correlation was found between the severity of vascular calcification and the calcium-phosphate metabolism. In the group with type 2 diabetes, there is a correlation between the level of FGF-23, iPTH, inorganic phosphorus and vascular calcification. There is also a correlation between the time on LTH and the increase in the level of FGF-23 in patients with type 2 diabetes.
 Conclusion. We obtained data that can indicate a more pronounced change in the vascular wall in patients with type 2 diabetes on LTH in comparison with patients without diabetes mellitus on LTH, which allows to associate high cardiovascular mortality in patients with type 2 diabetes on LTH with accelerated development of vascular calcification.