Background. Dialysis patients are known to have an increased risk of total and cardiovascular mortality. Previously we described that vascular calcification (VC) is an independent predictor of novel non-fatal cardiovascular events in haemodialysis (HD) patients. Fibroblast growth factor-23 (FGF 23) and Matrix Gla protein (MGP) are known to be important contributors for VC and mortality in HD patients. There have been studies analysing the associations between FGF 23, MGP and cardiovascular diseases, but not in the special cohort of maintenance HD patients.
Objective. To analyse the possible associations between biomarkers (FGF 23, MGP) and the incidence of cardiovascular diseases in HD patients.
Methods. This observational prospective single-centre study included 75 prevalent patients on maintenance HD. After evaluating VC, heart ultrasound, laboratory tests, levels of MGP and FGF 23, patients were observed for the incident of non-fatal cardiovascular events. A detailed analysis was performed in groups with (CVD group) and without (no CVD group) pre-existing cardiovascular diseases.
Results. Neither biomarkers nor heart ultrasound measures differed significantly in patients with and without new cardiovascular events in the CVD group. In the no CVD group univariate Cox regression analysis showed that the relative risk of novel cardiovascular event was 5.5 higher in patients with a FGF 23 level lower than 41 ng/L (p=0.008, 95% CI 1.6-19.7) and 5.9 higher in patients with a MGP level lower than 1.64 ng/mL (p=0.006, 95% CI 1.7-21).
Conclusions. We report a novel association of low FGF 23 and MGP levels and the incident of cardiovascular events in HD patients without pre-existing cardiovascular disease.
