Riri Andri Muzastia*, Netty Delvrita Lubisb
aDivision of Nephrology and Hypertension, Department of Internal Medicine, College of Medicine, Universitas Sumatera Utara, Medan, Indonesia, bDepartment of Radiology, Adam Malik Hospital, Medan, Indonesia
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Abstract
Objective: Homeostasis of serum phosphorus and calcitriol level is regulated mainly by fibroblast growth factor 23 (FGF23). Studies show that elevated serum FGF23 level was significantly associated with aortic calcification severity, peripheral blood vessels, and a higher score of coronary artery calcification in patients undergoing hemodialysis. We did this cross‑sectional study to determine the FGF23 diagnostic value for abdominal aortic calcification in Indonesian hemodialysis patients. Materials and Methods: This study included seventy‑five, chronic hemodialysis patients. An enzyme‑linked immunosorbent assay method was used to measure serum intact FGF23 level, and abdominal aortic calcification was detected by lateral lumbar X‑ray. The diagnostic value of FGF23 was analyzed using receiver operating characteristic (ROC) curves. Results: fifty‑one (68.0%) patients had abdominal aortic calcification (AAC). Serum intact FGF23 level ranged from 217 to 950 pg/mL with a median level of 328 pg/mL. The FGF23 levels in the serum of patients with AAC were significantly higher than those without AAC (P < 0.001). The best cutoff point was 277 pg/mL. The calculated area under the ROC curves was 0.959 (95% confidence interval, 0.912–1.00); sensitivity was 94.0% and specificity was 84.0% (P < 0.001). Conclusion: serum intact FGF23 level may be proposed as a proper tool for abdominal aortic calcification in Indonesian hemodialysis patients.
Keywords: Abdominal aortic calcification, Fibroblast growth factor 23, Hemodialysis
