Evaluation of Serum Fibroblast Growth Factor 23 for Cardiovascular Risk Prediction in Chronic Kidney Disease Patients: A Study Using the SCORE2 Risk Model

Background: Cardiovascular disease (CVD) is a major public health problem and the leading cause of morbidity and mortality in patients with chronic renal disease (CKD). The utility of Serum Fibro blast Growth Factor 23 (FGF23) as predictor of cardiovascular risk among CKD patients is evaluated in this study using SCORE2 risk model. Methods: To categorize participants into low medium and high cardiovascular risk groups, the SCORE2 risk model was used in this cross-sectional study of 150 CKD patients aged 40–75 years. Regression and ROC analysis of serum FGF23 levels and key cardiovascular biomarkers were performed. Results: We found that higher FGF23 levels were associated with higher cardiovascular risk (low risk: 64.88 pg/ml vs. High risk: 650.75 pg/ml; p<0.001). Through regression analysis, we demonstrated strong associations between FGF23 and inflammatory markers (hscrp, R²=0.777) as well as oxidative stress markers (MDA, R²=0.738). Analysis by ROC revealed high predictive capacity of FGF23 (AUC=0.851). Conclusion: FGF23 may serve as a biomarker for early cardiovascular risk stratification in CKD and a good marker for inclusion in cardiovascular risk models.