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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Calcinosis, Cardiomyopathies, Female, Fibroblast Growth Factors, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Prognosis, ROC Curve, Renal Insufficiency, Chronic.
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Does fibroblast growth factor 23 predict coronary calcification and poor prognosis in patients with chronic kidney disease stages 3-5D? Context: To investigate the relationship of fibroblast growth factor-23 (FGF23) to coronary calcification and prognosis in patients with chronic kidney disease (CKD) stages 3-5D. We determined serum levels of intact FGF23 in 150 patients with CKD stages 3-5D, using an enzyme-linked immunosorbent assay (ELISA). The coronary calcification was detected with multi-slice CT, and its relationship to FGF23 was analyzed. These patients were followed up over a period of 35±3 months. Serum FGF23 levels of patients with CKD stages 3-5D were significantly higher than those of the healthy control group (p<0.01). There was a significant positive correlation between serum FGF23 levels and coronary calcification score (CaS) (r=0.177, p<0.05). Age, dialysis vintage, and FGF23 levels were independent risk factors for coronary calcification in patients with CKD stages 3-5D. Receiver-operating characteristic (ROC) curves showed that the sensitivity and specificity of FGF23 were 62.5% and 75.9%, respectively, for diagnosing coronary calcification, with an area of 0.705 under the curve (p<0.01). Kaplan-Meier analysis revealed that survival rates were significantly better in patients with lower FGF23 levels (p<0.05). In Cox regression analysis, FGF23 levels and severe coronary calcification (CaS>400) were independent risk factors for all-cause mortality.
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Serum FGF23 level in patients with CKD stages 3-5D was significantly higher than in the healthy controls. These increased FGF23 levels are likely associated with coronary calcification and poor prognosis. Final Decision: yes