# The Severity of Carotid Calcifications, but Not Fibroblast Growth Factor 23, Is Associated with Mortality in Hemodialysis: A Single Center Experience

## TL;DR

This study found that the severity of carotid calcifications, not FGF-23, is linked to higher mortality in hemodialysis patients over 8 years.

## Contribution

The study identifies carotid vascular calcifications as an independent predictor of mortality in hemodialysis patients.

## Key findings

- Carotid VC score over 4 predicts all-cause and cardiovascular mortality in HD patients.
- Diabetes, low albumin, and high CRP are also linked to higher mortality.
- FGF-23 was not associated with mortality outcomes in this cohort.

## Abstract

Background. The study goal was to assess the mortality effect of carotid vascular calcifications (VC), of fibroblast growth factor 23 (FGF-23), mineral markers, and comorbidities in hemodialysis (HD) patients. Methods. The influence of carotid VC severity, FGF-23, laboratory markers, clinical features, and comorbidities on mortality was analyzed in a cohort of 88 HD patients. The follow-up period lasted 8 years. The cut-off value for carotid VC was 4 for all-cause and cardiovascular mortality. Results. Carotid VC, diabetes, low serum albumin, high serum C-reactive protein (CRP), and the presence of cardiovascular diseases are associated with all-cause and cardiovascular mortality. Carotid VC score over 4 was an independent predictor of all-cause and cardiovascular mortality, along with diabetes, low albumin, and high CRP. FGF-23 was not found to be predictable for the study outcomes. Conclusions. The study documented in a cohort of patients prevalent in chronic HD that carotid VC predicts all-cause and cardiovascular mortality at 8 years and improves risk stratification, but FGF-23 is not associated with mortality. Other risk factors for all-cause and cardiovascular mortality were diabetes, inflammation, and malnutrition. However, future efforts are needed to assess whether a risk-based approach, including VC screening, improves survival.