Progression of vascular calcification is associated with higher phosphate and lower MGP levels: one centre cohort study

Abstract

Introduction and Aims: The aim of the study was to evaluate progression of vascular calcification determined by simple vascular calcification score (SVCS) and to analyse possible relationship between Ca-P metabolism disorders as well as biomarker levels (Fibroblast growth factor 23 (FGF 23) and matrix Gla protein (MGP)) and vascular calcification progression in chronic hemodialysis patients. Methods: The SVCS was evaluated to all prevalent chronic hemodialysis patients in a hemodialysis centre starting February 2013 during the 7 month period. The analysis of plain radiographic films of pelvis and hands was performed by a single radiologist as it is described by Adragao et al. (Nephrology Dialysis Transplantation (2004) 19;1480- 88) with SVCS 3 considered as cut off value. At the start of the study 95 patients were involved and results were presented as abstracts in ERA EDTA congress 2016. During the follow up, 21 patient was transplanted, 34 died, 15 patients moved to other dialysis centres. 3 patients refused to perform the radiological test repeatedly. The study population consisted of remaining 22 hemodialysis patients. For evaluation of progression of vascular calcification, the radiograms were performed using the same radiological method and evaluated by the same radiologist for the remaining patients in 2months starting October 2017. Clinical data and laboratory test information was collected from medical records. Biochemical parameters (Ca, ionized Ca, P, PTH, ALP,) presented as the calculated average of all the tests performed during the period between two radiological tests. FGF 23 and MGP were measured at the moment of primary radiological evaluation. For the analysis patients were divided into two groups: 1 group- patients with the same SVCS on both tests, 2 group- patients with higher SVCS as compared to primary evaluation. Variables were expressed as frequencies for discrete factors and mean value.[...].