#2137 Systemic inflammation as a main factor in CKD-MBD development

Abstract Background and Aims Chronic kidney disease (CKD) is a progressive disorder that affects more than 10% of the general population worldwide. Despite great achievements in the field of treatment of CKD, patient mortality remains at a high level. Research into the pathophysiology and correction of this condition in the early stages of development is ongoing. The aim of the study was to establish relationship between systemic inflammation and mineral disorders in any stage of CKD. Method We investigated 5 groups of patients with different stages (I to V) of CKD 19-22 persons in each (total amount 106 patients), aged 49,6 years and 19 healthy individuals aged 41,9 years as control group. We examined the blood level of interleukin 1 beta (IL-1β), interleukin 6 (IL-6), interleukin 8 (IL-8), C-reactive protein (CRP) and c-terminal fragment of fibroblast factor 23 (FGF-23) in all patients and control group. Results The course of CKD is accompanied by systemic inflammation, which is characterized by an increase in IL-1β in the I stage of chronic kidney disease ((13,41 ± 3,36) pg/ml) (p 0.01), IL-6 in the III stage of chronic kidney disease (29,31 ± 5,49) pg/ml (p 0.01), IL-8 in the II stage of chronic kidney disease ((11,56 ± 2,72) pg/ml) (p 0.05) and CRP in the IV stage of chronic kidney disease ((7,22 (1,81; 10,8)) mg/ml (p 0.01), compared to the control group ((5,93 ± 3,65), (6,01 ± 1,67), (7,99 ± 1,17) pg/ml and (0,66 (0,41; 0,85)) mg/ml accordingly), and progresses with a decrease in glomerular filtration rate. Growing already at the initial stage of chronic kidney disease, the level of FGF-23 reached a statistical difference from the control group at the 2nd stage of CKD. A strong statistically significant relationship was found between FGF-23 and IL-6 (R = 0.84; p 0.01), IL-1β at GFR 15 ml/(min•1.73 m2) (R = 0.45; p 0.01) and IL-8 at GFR 15 ml/(min•1.73 m2) (R = 0.57; p 0.01). Conclusion Systemic inflammation appears in the initial stages of CKD, being a trigger for further kidney dysfunction and the development of mineral and bone disorders. Systemic inflammation treatment in patients with CKD is staying a magnetic but still unattainable goal that needs further efforts to invest.