Endothelial dysfunction in cronic kidney failure and its relation with fibroblast growth factor 21

The reasons leading to endothelial dysfunction in patients with cronic kidney disease (CKD) haven't been explained satisfactorily yet. Through this study, the relation of the serum ADMA level , an indicator of endotel dysfunctıon in patients with CKD, with FGF21, which is a new adipokinine, and other biochemical parameter which are related to cardiovasculer mortality are investigated.Fourty one cases, having CKD for the last 6 months and having GFR below 60 ml /min. Fourty three cases, hemodialysis treatment for the last 6 months, and 40 health volunteers were included to the study. Blood pressure of all subjects was examined and antropometric evoluotionwas performed. Serum biochemical tests, PTH, ADMA and FGF21 levels were studied.FGF 21 levels were found to be high in CRD cases in comparison with the control group, and FGF 21 levels were increased after HD seansion. While there was a positive correlation between the serum FGF 21 levels and duration of CKD, body-fat ratio, serum ADMA level, creatinine, CRP, calcium phosphorus product and PTH, a negative correlation was observed with the BMI, body water ratio, albumin, creatinine clearance and hemoglobine.These results suggested that there was a close relation between, serum FGF 21 level and ADMA, and other cardiovasculer risk factors such as anemia hypoalbuminemia, high CRP levels and elevated blood pressure. With this study the relationship between FGF 21 and ADMA, an indicator of endothelial dysfunction in CKD patients was determined for the first time.However, when CRF patients rather than all cases are evaluated, no relation is found with the other cardiovascular risk factors like anemia, serum albumine level, CRP and blood pressure. We thought that it was because the study has been carried out in small group. We believe that a larger scale study which will be done on FGF 21 will put a light on cardiovascular disease , anemia and malnutrition remedies.