| Objective: To investigate the relationship between fibroblast growth factor-23(FGF23),Klotho protein(Klotho)content and mineral metabolism abnormality and left ventricular hypertrophy(LVH)in Chronic kidney disease(CKD)patients without dialysis.Methods: A total of 103 patients,including 66 males and 37 females,who were diagnosed as stage 3-5 chronic kidney disease and did not receive renal replacement therapy in Affiliated hospital of yanbian university from February 2021 to August 2021 were selected as the control group,and a total of 25 healthy people who underwent physical examination during the same period were selected as the control group.The levels of FGF23 and Klotho in CKD group and normal group were determined by Elisa.At the same time,the general information,biochemical parameters and imaging examination of CKD3-5 patients were recorded,and statistical analysis was performed.Results: Under the condition of gradually decreased renal function,the level of FGF23 was gradually increased,and the level of Klotho was gradually decreased.From CKD stage 3 to 5,the levels of FGF23 and Klotho were significantly lower than those in the normal group(P<0.05).Compared with the patients in CKD3-4 stage group,the levels of blood phosphorus,blood calcium× blood phosphorus and i PTH in the CKD5 stage group were significantly increased(all P<0.05),while the blood calcium level was decreased(P<0.05),and the differences were statistically significant.The ALP gradually increased in all three groups of CKD patients but it was not statistically significant.In addition,in CKD,the LVH group compared with the non-LVH group revealed that the serum phosphorus,serum creatinine,and blood calcium × blood phosphorus were higher than those in the non-LVH group,while the blood calcium,EF%,and Klotho were lower than those in the non-LVH group(all P<0.05),all of which had statistical significance.The left ventricular mass fraction in patients with CKD5 was significantly higher than that in patients with CKD3(P<0.05),with statistical significance.In the correlation analysis,it was found that FGF23 had a positive correlation with blood phosphorus,i PTH,creatinine,and Cys-C(P<0.05),with statistical significance,but no significant correlation with blood calcium(P>0.05).In the Klotho correlation analysis,a negative correlation was found with blood phosphorus,blood creatinine,and FGF23(all P<0.05),with statistical significance.LVH was positively correlated with blood phosphorus and blood calcium × blood phosphorus(P<0.05),all with statistical significance,but negatively correlated with Klotho level(P<0.05),with statistical significance.Multiple linear regression analysis showed that Cys-c was a related factor affecting the level of FGF23 in patients with CKD,and blood phosphorus was a risk factor for left ventricular hypertrophy.Conclusion: 1.In CKD 3-5 non-dialysis patients,with the decrease of renal function,FGF23 will increase and Klotho will decrease,which is earlier than calcium phosphate metabolism disorder and PTH increase.Therefore,FGF23 and Klotho can be used as early indicators of renal impairment.2.Increased blood P and decreased Klotho in CKD stage 3-5 non-dialysis patients are associated with the development of LVH. |
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