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 4 th 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
Background and Aims 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). The study aims at early detection of breast arterial calcification (BAC) in different stages of CKD (stage 2, 3& 4) patients as an indicator of systemic VC. Method A case control study was conducted targeting CKD women, aged 18- 60 years old. The sample was divided into 3 groups; A,B,C (representing stage 2, 3 & 4 of CKD) from women who attended nephrology and Internal medicine clinics and admitted in inpatient ward in Suez Canal University Hospital. A 4th group (D) was formed as a control group and included women with normal kidney functions (each group (A, B, C, D) include 22 women). The selected participants were subjected to history taking, mammogram to detect BAC and biochemical assessment of lipid profile, Serum creatinine (Cr), Mg, P, Ca, PTH and FGF23. Results Our study detected presence of BAC in about 81.8% of hypertensive stage 4 CKD patients compared with 50% in stage 3 CKD, also in the majority of stage 4 CKD patients who had abnormal lipid profile parameters and electrolyte disturbance. Most of the variables had statistical significance regarding the presence of BAC. 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. These results suggest that preventive strategies may need to begin as early as stage 2 CKD.
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