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dc.contributor.authorCraver Hospital, Lourdes
dc.contributor.authorDusso Rosso, Adriana
dc.contributor.authorMartínez Alonso, Montserrat
dc.contributor.authorSarró, Felipe
dc.contributor.authorValdivielso Revilla, José Manuel
dc.contributor.authorFernández i Giráldez, Elvira
dc.date.accessioned2015-06-02T12:05:42Z
dc.date.available2015-06-02T12:05:42Z
dc.date.issued2013
dc.identifier.issn1471-2369
dc.identifier.urihttp://hdl.handle.net/10459.1/48287
dc.description.abstractBackground: Vascular calcification (VC) contributes to high mortality rates in chronic kidney disease (CKD). High serum phosphate and FGF23 levels and impaired phosphaturic response to FGF23 may affect VC. Therefore, their relative contribution to abdominal aortic calcification (AAC) was examined in patients CKD stages 3–4. Methods: Potential risk factors for AAC, measured by the Kauppila Index (KI), were studied in 178 patients. Results: In multivariate linear analysis, AAC associated positively with age, male gender, CKD-stage, presence of carotid plaques (CP) and also with FGF23, but negatively with fractional excretion of phosphate (FEP). Intriguingly, FEP increased with similar slopes with elevations in PTH, with reductions in GFR, and also with elevations in FGF23 but the latter only in patients with none (KI = 0) or mild (KI = 1-5) AAC. Lack of a FEP-FGF23 correlation in patients with severe AAC (KI > 5) suggested a role for an impaired phosphaturic response to FGF23 but not to PTH in AAC. Logistic and zero-inflated analysis confirmed the independent association of age, CKD stage, male gender and CP with AAC, and also identified a threshold FEP/FGF23 ratio of 1/3.9, below which the chances for a patient of presenting severe AAC increased by 3-fold. Accordingly, KI remained unchanged as FEP/FGF23 ratios decreased from 1/1 to 1/3.9 but markedly increased in parallel with further reductions in FEP/FGF23 < 1/3.9. Conclusions: In CKD 3–4, an impaired phosphaturic response to FGF23 with FEP/FGF23 < 1/3.9 associates with severe AAC independently of age, gender or CP.ca_ES
dc.language.isoengca_ES
dc.publisherBioMed Centralca_ES
dc.relation.isformatofReproducció del document publicat a https://doi.org/10.1186/1471-2369-14-221ca_ES
dc.relation.ispartofBMC Nephrology, 2013, vol. 14, núm. 221, p. 1-12ca_ES
dc.rightscc-by, (c) Craver et al., 2013ca_ES
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/es/*
dc.subjectVascular calcificationca_ES
dc.subjectFGF23ca_ES
dc.subjectFractional excretion of phosphateca_ES
dc.titleA low fractional excretion of Phosphate/Fgf23 ratio is associated with severe abdominal Aortic calcification in stage 3 and 4 kidney disease patientsca_ES
dc.typearticleca_ES
dc.identifier.idgrec021277
dc.type.versionpublishedVersionca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_ES
dc.identifier.doihttps://doi.org/10.1186/1471-2369-14-221


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cc-by, (c) Craver et al., 2013
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