Serum FGF23 and Risk of Cardiovascular Events in Relation to Mineral Metabolism and Cardiovascular Pathology
Circulating fibroblast growth factor-23 is associated with adverse cardiovascular outcomes in CKD and non-CKD individuals, but the underlying mechanism remains unclear. This study tested whether this association is independent of mineral metabolism and indices of subclinical cardiovascular pathology...
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| Veröffentlicht in: | Clinical journal of the American Society of Nephrology 2013-05, Vol.8 (5), p.781-786 |
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| creator | Ärnlöv, Johan Carlsson, Axel C Sundström, Johan Ingelsson, Erik Larsson, Anders Lind, Lars Larsson, Tobias E |
| description | Circulating fibroblast growth factor-23 is associated with adverse cardiovascular outcomes in CKD and non-CKD individuals, but the underlying mechanism remains unclear. This study tested whether this association is independent of mineral metabolism and indices of subclinical cardiovascular pathology.
The prospective association between fibroblast growth factor-23 and major cardiovascular events (a composite of hospital-treated myocardial infarction, hospital-treated stroke, or all-cause mortality) was investigated in the community-based Prospective Investigation of the Vasculature in Uppsala Seniors (n=973; mean age=70 years, 50% women) using multivariate logistic regression. Subjects were recruited between January of 2001 and June of 2004.
During follow-up (median=5.1 years), 112 participants suffered a major cardiovascular event. In logistic regression models adjusted for age, sex, and estimated GFR, higher fibroblast growth factor-23 was associated with increased risk for major cardiovascular events (odds ratio for tertiles 2 and 3 versus tertile 1=1.92, 95% confidence interval=1.19-3.09, P |
| doi_str_mv | 10.2215/CJN.09570912 |
| format | Article |
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The prospective association between fibroblast growth factor-23 and major cardiovascular events (a composite of hospital-treated myocardial infarction, hospital-treated stroke, or all-cause mortality) was investigated in the community-based Prospective Investigation of the Vasculature in Uppsala Seniors (n=973; mean age=70 years, 50% women) using multivariate logistic regression. Subjects were recruited between January of 2001 and June of 2004.
During follow-up (median=5.1 years), 112 participants suffered a major cardiovascular event. In logistic regression models adjusted for age, sex, and estimated GFR, higher fibroblast growth factor-23 was associated with increased risk for major cardiovascular events (odds ratio for tertiles 2 and 3 versus tertile 1=1.92, 95% confidence interval=1.19-3.09, P<0.01). After additional adjustments in the model, adding established cardiovascular risk factors, confounders of mineral metabolism (calcium, phosphate, parathyroid hormone, and 25(OH)-vitamin D), and indices of subclinical pathology (flow-mediated vasodilation, endothelial-dependent and -independent vasodilation, arterial stiffness, and atherosclerosis and left ventricular mass) attenuated this relationship, but it remained significant (odds ratio for tertiles 2 and 3 versus tertile 1=1.69, 95% confidence interval=1.01-2.82, P<0.05).
Fibroblast growth factor-23 is an independent predictor of cardiovascular events in the community, even after accounting for mineral metabolism abnormalities and subclinical cardiovascular damage. Circulating fibroblast growth factor-23 may reflect novel and important aspects of cardiovascular risk yet to be unraveled.</description><identifier>ISSN: 1555-9041</identifier><identifier>ISSN: 1555-905X</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.09570912</identifier><identifier>PMID: 23335040</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Aged ; Biomarkers - blood ; Bone Remodeling ; Calcium - blood ; Female ; Fibroblast Growth Factors - blood ; Glomerular Filtration Rate ; Health and Welfare ; Hemodynamics ; Hospitalization ; Humans ; Hälsa och välfärd ; Kardiologi ; Klinisk medicin ; Logistic Models ; Longitudinal Studies ; Male ; Medicin och hälsovetenskap ; Multivariate Analysis ; Myocardial Infarction - blood ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Njurmedicin ; Odds Ratio ; Original ; Parathyroid Hormone - blood ; Phosphates - blood ; Predictive Value of Tests ; Prospective Studies ; Renal Insufficiency, Chronic - blood ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - mortality ; Renal Insufficiency, Chronic - physiopathology ; Renal Insufficiency, Chronic - therapy ; Risk Assessment ; Risk Factors ; Stroke - blood ; Stroke - etiology ; Stroke - mortality ; Stroke - therapy ; Sweden ; Time Factors ; Urologi och njurmedicin ; Ventricular Function, Left ; Vitamin D - analogs & derivatives ; Vitamin D - blood</subject><ispartof>Clinical journal of the American Society of Nephrology, 2013-05, Vol.8 (5), p.781-786</ispartof><rights>Copyright © 2013 by the American Society of Nephrology 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c685t-681140e12f4840a9f7cfbe488417cae813183ac601443df245b6bae1fccbdbd33</citedby><cites>FETCH-LOGICAL-c685t-681140e12f4840a9f7cfbe488417cae813183ac601443df245b6bae1fccbdbd33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641622/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641622/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,553,728,781,785,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23335040$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:du-12679$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-201793$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:126715043$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Ärnlöv, Johan</creatorcontrib><creatorcontrib>Carlsson, Axel C</creatorcontrib><creatorcontrib>Sundström, Johan</creatorcontrib><creatorcontrib>Ingelsson, Erik</creatorcontrib><creatorcontrib>Larsson, Anders</creatorcontrib><creatorcontrib>Lind, Lars</creatorcontrib><creatorcontrib>Larsson, Tobias E</creatorcontrib><title>Serum FGF23 and Risk of Cardiovascular Events in Relation to Mineral Metabolism and Cardiovascular Pathology</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Circulating fibroblast growth factor-23 is associated with adverse cardiovascular outcomes in CKD and non-CKD individuals, but the underlying mechanism remains unclear. This study tested whether this association is independent of mineral metabolism and indices of subclinical cardiovascular pathology.
The prospective association between fibroblast growth factor-23 and major cardiovascular events (a composite of hospital-treated myocardial infarction, hospital-treated stroke, or all-cause mortality) was investigated in the community-based Prospective Investigation of the Vasculature in Uppsala Seniors (n=973; mean age=70 years, 50% women) using multivariate logistic regression. Subjects were recruited between January of 2001 and June of 2004.
During follow-up (median=5.1 years), 112 participants suffered a major cardiovascular event. In logistic regression models adjusted for age, sex, and estimated GFR, higher fibroblast growth factor-23 was associated with increased risk for major cardiovascular events (odds ratio for tertiles 2 and 3 versus tertile 1=1.92, 95% confidence interval=1.19-3.09, P<0.01). After additional adjustments in the model, adding established cardiovascular risk factors, confounders of mineral metabolism (calcium, phosphate, parathyroid hormone, and 25(OH)-vitamin D), and indices of subclinical pathology (flow-mediated vasodilation, endothelial-dependent and -independent vasodilation, arterial stiffness, and atherosclerosis and left ventricular mass) attenuated this relationship, but it remained significant (odds ratio for tertiles 2 and 3 versus tertile 1=1.69, 95% confidence interval=1.01-2.82, P<0.05).
Fibroblast growth factor-23 is an independent predictor of cardiovascular events in the community, even after accounting for mineral metabolism abnormalities and subclinical cardiovascular damage. Circulating fibroblast growth factor-23 may reflect novel and important aspects of cardiovascular risk yet to be unraveled.</description><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>Bone Remodeling</subject><subject>Calcium - blood</subject><subject>Female</subject><subject>Fibroblast Growth Factors - blood</subject><subject>Glomerular Filtration Rate</subject><subject>Health and Welfare</subject><subject>Hemodynamics</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Hälsa och välfärd</subject><subject>Kardiologi</subject><subject>Klinisk medicin</subject><subject>Logistic Models</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicin och hälsovetenskap</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Njurmedicin</subject><subject>Odds Ratio</subject><subject>Original</subject><subject>Parathyroid Hormone - blood</subject><subject>Phosphates - blood</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Renal Insufficiency, Chronic - blood</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Renal Insufficiency, Chronic - mortality</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Renal Insufficiency, Chronic - therapy</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke - blood</subject><subject>Stroke - etiology</subject><subject>Stroke - mortality</subject><subject>Stroke - therapy</subject><subject>Sweden</subject><subject>Time Factors</subject><subject>Urologi och njurmedicin</subject><subject>Ventricular Function, Left</subject><subject>Vitamin D - analogs & derivatives</subject><subject>Vitamin D - blood</subject><issn>1555-9041</issn><issn>1555-905X</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNqFkktv1DAUhSMEoqWwY428QkiQ4utXkg1SNXQKqAVUHmJnOY4z49aJBzuZqv8eT-dRilSx8pX93XMfPln2HPAhIcDfTj59PsQVL3AF5EG2D5zzvML818NdzGAvexLjBcaMUcIfZ3uEUsoxw_uZ-2bC2KHpyZRQpPoGndt4iXyLJio01i9V1KNTAR0vTT9EZHt0bpwarO_R4NGZ7U1QDp2ZQdXe2djdaPyT-1UNc-_87Ppp9qhVLppnm_Mg-zE9_j75kJ9-Ofk4OTrNtSj5kIsSgGEDpGUlw6pqC93WhpUlg0IrUwKFkiotMKR5mpYwXotaGWi1rpu6ofQgy9e68cosxlougu1UuJZeWbm5ukyRkZxCVYnEV_fyi-Cb26RtIhBRQNrgqtabe3Pf259H0oeZHEdJMBTVCn_9f7wZbwpUiX63phPamUanP0jrvtvfnZfezuXMLyUVDAQhSeDVRiD436OJg-xs1MY51Rs_Rgm0wILyiorbQXTwMQbT7soAliunyeQ0uXVawl_83doO3lorAS_XwNzO5lc2GBk75VzCidQXKval5LJIn_kHu-7fAw</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Ärnlöv, Johan</creator><creator>Carlsson, Axel C</creator><creator>Sundström, Johan</creator><creator>Ingelsson, Erik</creator><creator>Larsson, Anders</creator><creator>Lind, Lars</creator><creator>Larsson, Tobias E</creator><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><scope>DF2</scope></search><sort><creationdate>20130501</creationdate><title>Serum FGF23 and Risk of Cardiovascular Events in Relation to Mineral Metabolism and Cardiovascular Pathology</title><author>Ärnlöv, Johan ; Carlsson, Axel C ; Sundström, Johan ; Ingelsson, Erik ; Larsson, Anders ; Lind, Lars ; Larsson, Tobias E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c685t-681140e12f4840a9f7cfbe488417cae813183ac601443df245b6bae1fccbdbd33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>Bone Remodeling</topic><topic>Calcium - blood</topic><topic>Female</topic><topic>Fibroblast Growth Factors - blood</topic><topic>Glomerular Filtration Rate</topic><topic>Health and Welfare</topic><topic>Hemodynamics</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Hälsa och välfärd</topic><topic>Kardiologi</topic><topic>Klinisk medicin</topic><topic>Logistic Models</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicin och hälsovetenskap</topic><topic>Multivariate Analysis</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Njurmedicin</topic><topic>Odds Ratio</topic><topic>Original</topic><topic>Parathyroid Hormone - blood</topic><topic>Phosphates - blood</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Renal Insufficiency, Chronic - blood</topic><topic>Renal Insufficiency, Chronic - complications</topic><topic>Renal Insufficiency, Chronic - mortality</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Renal Insufficiency, Chronic - therapy</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke - blood</topic><topic>Stroke - etiology</topic><topic>Stroke - mortality</topic><topic>Stroke - therapy</topic><topic>Sweden</topic><topic>Time Factors</topic><topic>Urologi och njurmedicin</topic><topic>Ventricular Function, Left</topic><topic>Vitamin D - analogs & derivatives</topic><topic>Vitamin D - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ärnlöv, Johan</creatorcontrib><creatorcontrib>Carlsson, Axel C</creatorcontrib><creatorcontrib>Sundström, Johan</creatorcontrib><creatorcontrib>Ingelsson, Erik</creatorcontrib><creatorcontrib>Larsson, Anders</creatorcontrib><creatorcontrib>Lind, Lars</creatorcontrib><creatorcontrib>Larsson, Tobias E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Uppsala universitet</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ärnlöv, Johan</au><au>Carlsson, Axel C</au><au>Sundström, Johan</au><au>Ingelsson, Erik</au><au>Larsson, Anders</au><au>Lind, Lars</au><au>Larsson, Tobias E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum FGF23 and Risk of Cardiovascular Events in Relation to Mineral Metabolism and Cardiovascular Pathology</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>8</volume><issue>5</issue><spage>781</spage><epage>786</epage><pages>781-786</pages><issn>1555-9041</issn><issn>1555-905X</issn><eissn>1555-905X</eissn><abstract>Circulating fibroblast growth factor-23 is associated with adverse cardiovascular outcomes in CKD and non-CKD individuals, but the underlying mechanism remains unclear. This study tested whether this association is independent of mineral metabolism and indices of subclinical cardiovascular pathology.
The prospective association between fibroblast growth factor-23 and major cardiovascular events (a composite of hospital-treated myocardial infarction, hospital-treated stroke, or all-cause mortality) was investigated in the community-based Prospective Investigation of the Vasculature in Uppsala Seniors (n=973; mean age=70 years, 50% women) using multivariate logistic regression. Subjects were recruited between January of 2001 and June of 2004.
During follow-up (median=5.1 years), 112 participants suffered a major cardiovascular event. In logistic regression models adjusted for age, sex, and estimated GFR, higher fibroblast growth factor-23 was associated with increased risk for major cardiovascular events (odds ratio for tertiles 2 and 3 versus tertile 1=1.92, 95% confidence interval=1.19-3.09, P<0.01). After additional adjustments in the model, adding established cardiovascular risk factors, confounders of mineral metabolism (calcium, phosphate, parathyroid hormone, and 25(OH)-vitamin D), and indices of subclinical pathology (flow-mediated vasodilation, endothelial-dependent and -independent vasodilation, arterial stiffness, and atherosclerosis and left ventricular mass) attenuated this relationship, but it remained significant (odds ratio for tertiles 2 and 3 versus tertile 1=1.69, 95% confidence interval=1.01-2.82, P<0.05).
Fibroblast growth factor-23 is an independent predictor of cardiovascular events in the community, even after accounting for mineral metabolism abnormalities and subclinical cardiovascular damage. Circulating fibroblast growth factor-23 may reflect novel and important aspects of cardiovascular risk yet to be unraveled.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>23335040</pmid><doi>10.2215/CJN.09570912</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SWEPUB Freely available online; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Biomarkers - blood Bone Remodeling Calcium - blood Female Fibroblast Growth Factors - blood Glomerular Filtration Rate Health and Welfare Hemodynamics Hospitalization Humans Hälsa och välfärd Kardiologi Klinisk medicin Logistic Models Longitudinal Studies Male Medicin och hälsovetenskap Multivariate Analysis Myocardial Infarction - blood Myocardial Infarction - etiology Myocardial Infarction - mortality Myocardial Infarction - physiopathology Myocardial Infarction - therapy Njurmedicin Odds Ratio Original Parathyroid Hormone - blood Phosphates - blood Predictive Value of Tests Prospective Studies Renal Insufficiency, Chronic - blood Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - mortality Renal Insufficiency, Chronic - physiopathology Renal Insufficiency, Chronic - therapy Risk Assessment Risk Factors Stroke - blood Stroke - etiology Stroke - mortality Stroke - therapy Sweden Time Factors Urologi och njurmedicin Ventricular Function, Left Vitamin D - analogs & derivatives Vitamin D - blood |
| title | Serum FGF23 and Risk of Cardiovascular Events in Relation to Mineral Metabolism and Cardiovascular Pathology |
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