Cardiovascular disease is the most common cause of death in patients with chronic kidney disease. Diastolic dysfunction is an important risk factor resulting in development of advanced cardiovascular diseases. Fibroblast Growth Factor 23 is a hormone derived from bone osteocytes, FGF23's primary function is to increase renal excretion of phosphate, with klotho acting as a co-factor. A proposed mechanism for FGF23's effect on the heart is the activation of FGF receptor-4 on cardiac myocytes to stimulate phospholipase C/calcineurin-nuclear factor of activated T cell signaling. FGF23 is massively elevated in ESRD patients on HD. Elevation of FGF23 is one of the possible causes of diastolic dysfunction.
AIM OF THE WORK:
The aim of this study was to study the relation between FGF 23 and diastolic dysfunction in CKD patients and those maintained on hemodialysis.
PATIENTS AND METHODS:
Patients:
This study included 120 subjects divided into three groups:
Group I: 40 CKD patients on MHD. Group II: 40 CKD patients (stage IV).
Group III: 40 healthy persons as controls. Patients had been selected from those attending the outpatient Nephrology and Internal Medicine clinics of the Main Alexandria University Hospital and the Dialysis Unit of Alexandria Fever Hospital.
Their ages ranged between (20-40 years old). Patients maintained on regular hemodialysis at least 6 months.