Association of Fibroblast Growth Factor-23 and Early Detection of Breast Arterial Calcification in Different Stages of Chronic Kidney Disease Patients

Document Type : Original Article

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1 Department of Internal Medicine and Nephrology, Faculty of Medicine, Suez Canal University, Egypt

2 Department of Diagnostic Radiology, Faculty of Medicine, Suez Canal University, Egypt

Abstract

Background:Vascular calcification (VC) plays a major role in cardiovascular disease (CVD), which is one of the main causes of mortality in patients with chronic kidney disease (CKD). During the early stages of CKD, Fibroblast growth factor-23 (FGF-23) levels increase to keep serum phosphorus within the normal range. FGF23 may be associated with death and cardiovascular events in CKD patients. Aim:The study aimed at early detection of breast arterial calcification (BAC) and higher levels of FGF-23 as indicators of systemic VC in patients with different stages of CKD. Methodology: The patients were divided into 3 groups; representing stages 2, 3 & 4 of CKD women, and the 4th group was considered as a control group. The selected participants were subjected to history taking, mammogram to detect BAC and biochemical assessment of lipid profile, Serum creatinine, Mg, P, Ca, PTH and FGF23. Results: the presence of BAC in about 81.8% of stage 4 CKD patients compared with 50% in stage 3 CKD, also in the majority of stage 4 CKD patients had high FGF-23. Receiver operator characteristic (ROC) curve analysis showed serum FGF-23 as a potential predictor of BAC (AUC=0.874) in CKD patients at the cut-off point of 77.5ng/ml (sensitivity 78%, specificity 76%). Conclusion: Although it is difficult to determine the definite stage at which the risk of VC begins but, in our study, it began late in stage 2 CKD, gradually increased prevalence through stage 3, and became significantly higher in stage 4. FGF-23 could be a good predictor of BAC in CKD
 

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