ObjectiveTo investigate the effects of fibroblast growth factor-21(FGF-21) and bone morphogenetic protein-2(BMP-2) on vascular calcification of autologous arteriovenous fistula(AVF) in maintenance hemodialysis patients.

MethodsTwenty maintenance hemodialysis patients treated with internal fistula repair and 20 patients treated with primary internal fistula operation at stage 4-5 of chronic kidney disease in the Department of Nephrology of The First Affiliated Hospital of Bengbu Medical College were selected as the observation group, and 20 healthy people matched with age and gender in the health examination center were selected as the control group.The internal fistula blood vessels from establishing autogenous arteriovenous fistula operation(cephalic vein tissue of early fistula patients or arterialized venous cephalic vein of repairing fistula patients) were stained with alizarin red S to detect the presence of calcification, and calculate the calcification score for calcified stage(including severe calcification group, light and moderate calcification group and noncalcification group).The clinical data, serum biochemical parameters, and brachial and ankle pulse wave conduction velocity(baPWV) in all cases were collected.The serum concentrations of FGF-21 and BMP-2 in all cases were determined by ELISA, the immunohistochemistry was used to detect the expression levels of FGF-21 and BMP-2 in the vascular wall of internal fistula in the observation group.

ResultsThe serum levels of FGF-21 and BMP-2 in observation group were significantly higher than those in control group(P < 0.01).With the aggravation of vascular calcification, the serum levels of FGF-21 and BMP-2 increased, and the expression levels of FGF-21 and BMP-2 in the immune tissue of the vascular wall with higher calcification degree also increased(P < 0.05).The levels of FGF-21, BMP-2, serum phosphorus, creatinine, parathyroid hormone and baPWV in the observation group were positively correlated with the vascular calcification of internal fistula(r_s=0.850, 0.769, 0.718, 0.433, 0.441 and 0.457, respectively)(P < 0.01).

ConclusionsThe levels of FGF-21 and BMP-2 are correlated with the vascular calcification of autologous arteriovenous fistula in patients with maintenance hemodialysis, which can be used as the reference for monitoring the vascular calcification of internal fistula.