Fibroblast growth factor-23 is independently associated with the left ventricular mass index in hemodialysis patients

Abstract

Context Left ventricle (LV) hypertrophy is an important cardiovascular complication in chronic kidney disease that leads to LV dysfunction and increased mortality. Studies that tested the association between fibroblast growth factor (FGF)-23 and LV structural and functional changes in hemodialysis (HD) patients have shown conflicting results. Aims The aim of this work was to study whether FGF-23 has a direct association with LV structural and functional changes in HD patients. Settings and design This is a cross-sectional study. Materials and methods Demographic data of 95 HD patients were recorded in a predefined data sheets. The blood samples for FGF-23 and other laboratory variables were collected and measured by the standard methods. Echocardiography area length method was used to calculate left ventricular mass index (LVMI), and modified Simpson’s rule was used to measure ejection fraction. Transmitral Doppler and tissue Doppler of septal e′ were used to measure LV diastolic function. Statistical analysis Multivariate analysis was carried out. Results There were significant positive correlations between FGF-23 and LVMI (r=0.285, P=0.005) and LV E/e′ ratio (r=0.391, P=0.001), while there were insignificant correlations with other echocardiographic parameters including chamber dimensions, chamber volumes and PASP. Multivariate analysis showed a significant association between LVMI and FGF-23 level after adjustment for age and systolic BP (P=0.0001). Conclusion FGF-23 is independently associated with LVMI in HD patients. This result suggests a direct role of elevated FGF-23 in the pathogenesis of LV hypertrophy in patients with HD.