OBJECTIVE: Clinical and experimental evidence support a role for fibroblast growth factor (FGF-23) in promoting osteoclastic bone resorption, but the precise molecular mechanisms are not yet fully understood. FGF-23 has been implicated in chronic kidney disease (CKD) and is important in humans for osteogenesis. However, to date the possible role of FGF-23 in secondary hyperparathyroidism (SHP) is still unclear. The aim of this study was to investigate the serum levels of FGF-23 and its potential correlation with blood pressure, atherosclerotic markers and albuminuria in patients with early stages of CKD.DESIGN AND METHOD: CKD patients (n = 50) of stages 1 and 2 with type 2 diabetic nephropathy (DN, n = 25) and chronic glomerulonephritis, (CG, n = 25) were included. As controls, there were two groups, patients with diabetes type 2 without CKD (n = 40) and healthy individuals (n = 40). FGF-23 levels were measured by an ELISA method. Blood pressure (BP) was taken using a manual sphygmomanometer. Intima media thickness (IMT) of carotid arteries as a sub-atherosclerotic marker and presence of atherosclerotic plaque were evaluated by a high resolution ultrasonography. Statistical analysis was performed with the use of a SPSS system.RESULTS: The levels of FGF-23 were significantly higher in patients than in the control groups (0.5 ± 0.1, p < 0.004). IMT was also significantly higher in patients than in the control groups (0.35 ± 0.15, p < 0.001) and albuminuria (300 ± 150, p < 0.0001). There was negative strong correlation between FGF-23 and GFR (r = -0.75, p < 0.005), and positive strong correlation between FGF-23 and BP (0.7, p < 0.0001), between FGF-23 and IMT (r = 0.85, p < 0.0001) and FGF-23 and albuminuria (r = 0.75, p < 0.0001). Further, FGF-23 levels were independent correlates of BP, IMT and albuminuria.CONCLUSIONS: This study suggests that serum levels of FGF-23 were strongly correlated with BP, IMT, atheromatic plaque as well as with albuminuria, attributing a role for FGF-23 in atherosclerosis of CKD patients. FGF-23 might present an independent correlate of atherosclerosis in early stages of CKD.