Changes Of FGF23 And KLOTHO Before And After Taking Phosphate Binding Agent In Hemodialysis Patients And Effect On Cardiovascular Events

Objective:1.To investigate the changes of fibroblast growth factor 23 and KLOTHO protein levels in maintenance hemodialysis patients with hyperphosphatism before and after taking calcium and phosphorus binders and non-calcium and phosphorus binders.2.To observe the effects of calcium and phosphorus binders and non-calcium and phosphorus binders on cardiovascular events in maintenance hemodialysis patients with hyperphosphatism.Methods:Selective analysis of patients with chronic kidney disease at the end of September 2015 to September 2016 who underwent maintenance hemodialysis at the hemodialysis center of the Second Hospital of Tianjin Medical University and complicated with hyperphosphorus,Fifty patients who volunteered to take calcium and phosphorus binders were selected,Fifty patients volunteered to take non-calcium-phosphorus binders.All patients received maintenance hemodialysis for more than one year.They were divided into two groups and were treated regularly with hemodialysis three times a week for 4 hours each time.Group A volunteered to take calcium-phosphorus binder for phosphorus reduction(such as calcium carbonate,calcium acetate,etc.)and group B volunteered to take non-calcium-phosphorus binder(lanthanum carbonate,sveram,etc.).Serum was collected at 0,1,3,6 and 12 months after maintenance Serum phosphorus hyperphosphatism.The results of hemodialysis patients(P),calcium(Ca),parathyroid hormone(PTH),fibroblast growth factor 23 and KLOTHO protein in group A(taking calcium-phosphorus binder voluntarily)and group B(taking non-calcium-phosphorus binder voluntarily)before maintenance hemodialysis were analyzed.Results:Compared with group A,serum phosphorus,fibroblast growth factor 23 protein and KLOTHO protein in group B decreased Significantly,while in the group A cardiovascular events,Klotho protein was infected.The disease group was significantly higher than A.Differences were statistically significant.Multivariate logistic regression analysis showed high fibroblast growth factor 23 and low Klotho protein concentrations.High PTH was an independent risk factor for cardiovascular events in maintenance hemodialysis patients with high phosphorus(P < 0.01 or P <0.05).Conclusion:compared with the traditional phosphorus reducing drugs,non calcium containing phosphate binders can significantly reduce serum phosphorus,FGF23 and PTH,increase KLOTHO,reduce the incidence of cardiovascular events.Increased FGF23,PTH and KLOTHO protein in the blood were independent risk factors for cardiovascular events in patients with high serum phosphorus.