Hamit Yaşar ELLİDAĞ, Bekir EROL, Melahat ÇOBAN, Yıldız KILAR SÖZER, Emre ASILTÜRK, Üstün YILMAZ, Süleyman DOLU

Hemodiyaliz Hastalarında Intak Fibroblast Büyüme Faktörü 23 ve Periferik Damar Komplikasyonları

Amaç: Hemodiyaliz hastalarında sık görülen periferik damar komplikasyonları mortalite ile ilişkilidir. Fibroblast büyüme faktörü 23 (FGF23)'ün hemodiyaliz hastalarında mortaliteye neden olan fosfatürik bir hormon olduğu düşünülmektedir. Çalışmamızın amacı, hemodiyaliz hastalarında intak FGF23 (I-FGF23) ile aterosklerotik periferik damar komplikasyonları arasındaki ilişkiyi belirlemekti. Yöntemler: Bu kesitsel çalışma 50 [28 (%56) erkek, 22 (%44) kadın] hemodiyaliz hastası ile yapıldı. Hastalar yaş ve cinsiyet benzer 40 sağlıklı bireyle karşılaştırıldı. Ateroskleroz gelişimi karotis intima media kalınlığı (KIMK) ve arteriyel sertlik gelişimi brakiyal ayak bileği nabzı dalga hızı (NDH) aleti ile belirlendi. Bulgular: Hastalarda sağlıklı bireylere göre yüksek I-FGF23 düzeyleri ve düşük alfa-klotho (α-KL) düzeyleri ile birlikte artmış ateroskleroz ve arteriyel sertlik gelişimi gözlendi. I-FGF23 ile lipid profili arasında ters ve diğer faktörlerden bağımsız bir ilişki gözlendi. I-FGF23 ile ateroskleroz ve arteriyel sertlik arasında ilişki gözlenmedi. Tartışma: Serum I-FGF23 ile aterosklerotik periferik damar komplikasyonları arasında ilişki yoktu. Hemodiyaliz hastalarında I-FGF23 ile mortalite arasındaki ilişkinin nedeni periferik damar komplikasyonları dışındaki diğer kardiyovasküler olaylardan kaynaklanıyor olabilir.

Intact Fibroblast Growth Factor 23 and Peripheral Vascular Complications in Patients on Hemodialysis

Objective: Peripheral vascular complications frequently seen in hemodialysis patients are associated with mortality.Fibroblast growth factor 23 (FGF23) is thought to be a phosphaturic hormone that causes mortality in hemodialysispatients. The purpose of our study was to determine the association of intact FGF23 (I-FGF23) with atheroscleroticperipheral vascular complications in patients on hemodialysis.Methods: This cross-sectional study was performed with 50 [28 (56%) male, 22 (44%) female] hemodialysis patients.Patient characteristics were compared with an age +- and sex-matched control group of 40 healthy volunteers.Atherosclerosis development was measured by carotid intima media thickness (CIMT) and arterial stiffness developmentwas measured by brachial ankle pulse wave velocity (PWV) device.Results: Increased atherosclerosis and arterial stiffness were observed in patients with high I-FGF23 and low alphaklotho (α-KL) levels compared to healthy subjects. I-FGF23 showed an inverse and independent relationship betweenlipid profile. There was no relationship between I-FGF23 and atherosclerosis and arterial stiffness.Conclusion: There was no association between serum I-FGF23 and atherosclerotic peripheral vascular complications.The association between I-FGF23 and mortality may be due to cardiovascular events other than peripheral vascularcomplications in patients on hemodialysis.

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