P0908FGF-23, MBD AND INFLAMMATION IN CKD

Abstract Background and Aims Systemic inflammation, as well as Mineral and Bone Disease, are seen to be inherent complications of CKD, tightly related to cardio-vascular disease, protein-energy wasting and general mortality. It remains an actual problem to study relation between systemic inflammation and CKD-MBD. The aim of the study was to evaluate serum concentrations of c-terminal FGF-23 as an early marker of CKD MBD, Il-1 β, Il-6, Il-8 as inflammatory markers, and to establish relationships between FGF-23 and IL-1 β, Il-6, Il-8. Method The study involved 106 patients with CKD stages from 1 to 4, 47 women (44%) and 59 men (56%) aged from 35 to 72, mean (49.6± 13.9) years. The C-terminal FGF-23 fragment was determined using a set of reagents for the enzyme immunoassay «Biomedica». Concentration of IL-1β, IL-6 and IL-8 was determined using an assay «Vector BEST». The glomerular filtration rate (GFR) was calculated using the CKD EPI formula (KDIGO 2012). Results A progressive growth in FGF-23 levels was observed simultaneously with GFR decrease in patients with CKD. IL-1 concentration increased from CKD stage 1 ((12.64±4.30) pg/ml) to 4 ((32.06±7.86) pg/ml) (p <0.05) accordingly GFR fall, as well as the level of IL-6 ((7.25±2.14) pg/ml to (46.27±10,06)pg/ml) and Il-8 ((9.39±1.62) pg/ml to (33.00±9.17)pg/ml). The existence of a strong direct association (r = 0.84, p <0.05) between the level of Il-6 and FGF-23 in CKD stages 1-4 was established. IL-1 and Il-8 were found to have a medium strength assotiation (r=0.45, p <0.05 and r=0.57, p <0.05, accordingly) with FGF-23 concentration in patients with CKD stages 2-4. Conclusion The increase in the concentration of inflammatory factors along with progression of chronic renal failure was revealed. The existence of a strong link between the level of IL-6 and the C-terminal fragment of FGF-23 in CKD was established. Finding out the issue of the primary stimulation factor of FGF-23 production in CKD requires further research.