{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T01:00:28Z","timestamp":1777424428714,"version":"3.51.4"},"reference-count":64,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T00:00:00Z","timestamp":1644883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007044","name":"Sociedade Portuguesa de Nefrologia","doi-asserted-by":"publisher","award":["projects funding 2017 and 2019"],"award-info":[{"award-number":["projects funding 2017 and 2019"]}],"id":[{"id":"10.13039\/501100007044","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["transitional provision DL57\/2016\/CP1361\/CT0006"],"award-info":[{"award-number":["transitional provision DL57\/2016\/CP1361\/CT0006"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["project UIDB\/04326\/2020"],"award-info":[{"award-number":["project UIDB\/04326\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Accelerated and premature cardiovascular calcification is a hallmark of chronic kidney disease (CKD) patients. Valvular calcification (VC) is a critical indicator of cardiovascular disease and all-cause mortality in this population, lacking validated biomarkers for early diagnosis. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor recently associated with vascular calcification, pulse pressure, mineral metabolism markers and kidney function. Here, we examined the association between GRP serum levels and mitral and aortic valves calcification in a cohort of 80 diabetic patients with CKD stages 2\u20134. Mitral and aortic valves calcification were detected in 36.2% and 34.4% of the patients and associated with lower GRP levels, even after adjustments for age and gender. In this pilot study, univariate, multivariate and Poisson regression analysis, show that low levels of GRP and magnesium (Mg), and high levels of phosphate (P) are associated with mitral and aortic valves calcification. Receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) values of GRP for mitral (0.762) and aortic (0.802) valves calcification were higher than those of Mg and P. These results suggest that low levels of GRP and Mg, and high levels of P, are independent and cumulative risk factors for VC in this population; the GRP diagnostic value might be potentially useful in cardiovascular risk assessment.<\/jats:p>","DOI":"10.3390\/diagnostics12020496","type":"journal-article","created":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T22:43:22Z","timestamp":1644965002000},"page":"496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Gla-Rich Protein, Magnesium and Phosphate Associate with Mitral and Aortic Valves Calcification in Diabetic Patients with Moderate CKD"],"prefix":"10.3390","volume":"12","author":[{"given":"Ana P.","family":"Silva","sequence":"first","affiliation":[{"name":"Department of Nephrology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"},{"name":"Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"given":"Carla S. B.","family":"Viegas","sequence":"additional","affiliation":[{"name":"Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"},{"name":"GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"given":"Patr\u00edcia","family":"Guilherme","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Nelson","family":"Tavares","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Carolina","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal"},{"name":"Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"given":"F\u00e1tima","family":"Rato","sequence":"additional","affiliation":[{"name":"Pathology Clinic, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"N\u00e9lio","family":"Santos","sequence":"additional","affiliation":[{"name":"Pathology Clinic, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Mar\u00edlia","family":"Fa\u00edsca","sequence":"additional","affiliation":[{"name":"Pathology Clinic, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Edgar","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Centro Cardiovascular da Universidade de Lisboa (CCUL), 1649-028 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8463-0768","authenticated-orcid":false,"given":"Pedro L.","family":"Neves","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"},{"name":"Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5145-4753","authenticated-orcid":false,"given":"Dina C.","family":"Simes","sequence":"additional","affiliation":[{"name":"Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"},{"name":"GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1681\/ASN.2008070692","article-title":"Vascular calcification: The killer of patients with chronic kidney disease","volume":"20","author":"Mizobuchi","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/ndt\/gfv111","article-title":"Vascular calcification in chronic kidney disease: An update","volume":"31","author":"Schlieper","year":"2016","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_3","first-page":"2918","article-title":"Cardiovascular disease and its relationship with chronic kidney disease","volume":"18","author":"Liu","year":"2014","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s11883-016-0601-6","article-title":"Imaging Atherosclerotic Plaque Calcification: Translating Biology","volume":"18","author":"Bailey","year":"2016","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1038\/sj.ki.5002164","article-title":"Association of pulse wave velocity with vascular and valvular calcification in hemodialysis patients","volume":"71","author":"Raggi","year":"2007","journal-title":"Kidney Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3389\/fendo.2012.00095","article-title":"Mechanisms and clinical consequences of vascular calcification","volume":"3","author":"Zhu","year":"2012","journal-title":"Front. Endocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1016\/j.jacc.2012.02.093","article-title":"Calcific aortic stenosis: A disease of the valve and the myocardium","volume":"60","author":"Dweck","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/j.ackd.2019.10.004","article-title":"Valvular Calcification in Chronic Kidney Disease","volume":"26","author":"Brandenburg","year":"2019","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/01.ASN.0000038685.95946.83","article-title":"Cardiac valve calcification as an important predictor for all-cause mortality and cardiovascular mortality in long-term peritoneal dialysis patients: A prospective study","volume":"14","author":"Wang","year":"2003","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1681\/ASN.2004070610","article-title":"Association between chronic kidney disease and coronary artery calcification: The Dallas Heart Study","volume":"16","author":"Kramer","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1053\/j.ajkd.2007.05.020","article-title":"Kidney function and aortic valve and mitral annular calcification in the Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"50","author":"Ix","year":"2007","journal-title":"Am. J. Kidney Dis."},{"key":"ref_12","first-page":"217","article-title":"Evolutive aortic stenosis in hemodialysis patients: Analysis of risk factors","volume":"20","author":"Malergue","year":"1999","journal-title":"Nephrologie"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1093\/ndt\/gfz133","article-title":"Valvular heart disease and calcification in CKD: More common than appreciated","volume":"35","author":"Raggi","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1053\/j.ajkd.2008.04.012","article-title":"Prevalence and associations of coronary artery calcification in patients with stages 3 to 5 CKD without cardiovascular disease","volume":"52","author":"Garland","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1016\/j.amjcard.2015.02.011","article-title":"CRIC Study Investigators. Relation of aortic valve calcium to chronic kidney disease (from the Chronic Renal Insufficiency Cohort Study)","volume":"115","author":"Guerraty","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_16","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group (2009). KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease\u2013mineral and bone disorder (CKD-MBD). Kidney Int. Suppl., 76, S1\u2013S130."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.kint.2019.06.025","article-title":"Chronic kidney disease and valvular heart disease: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference","volume":"96","author":"Marwick","year":"2019","journal-title":"Kidney Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1476-7120-5-14","article-title":"Mitral annulus calcification is associated with valvular and cardiac structural abnormalities","volume":"5","author":"Movahed","year":"2007","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4349","DOI":"10.1093\/eurheartj\/ehaa485","article-title":"Timing of intervention in asymptomatic patients with valvular heart disease","volume":"41","author":"Baumgartner","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7082","DOI":"10.1074\/jbc.M702792200","article-title":"Ucma, a novel secreted cartilage-specific protein with implications in osteogenesis","volume":"283","author":"Dietz","year":"2008","journal-title":"J. Biol. Chem."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1161\/ATVBAHA.114.304823","article-title":"Gla-rich protein acts as a calcification inhibitor in the human cardiovascular system","volume":"35","author":"Viegas","year":"2015","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1161\/ATVBAHA.117.310578","article-title":"Chronic kidney disease circulating calciprotein particles and extracellular vesicles promote vascular calcification: A role for GRP (Gla-rich protein)","volume":"38","author":"Viegas","year":"2018","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Viegas, C.S., Costa, R.M., Santos, L., Videira, P.A., Silva, Z., Ara\u00fajo, N., Macedo, A.L., Matos, A.P., Vermeer, C., and Simes, D.C. (2017). Gla-rich protein function as an anti-inflammatory agent in monocytes\/macrophages: Implications for calcification-related chronic inflammatory diseases. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0177829"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Silva, A.P., Viegas, C.S., Mendes, F., Macedo, A., Guilherme, P., Tavares, N., Dias, C., Rato, F., Santos, N., and Fa\u00edsca, M. (2020). Gla-Rich Protein (GRP) as an Early and Novel Marker of Vascular Calcification and Kidney Dysfunction in Diabetic Patients with CKD: A Pilot Cross-Sectional Study. J. Clin. Med., 9.","DOI":"10.3390\/jcm9030635"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.2337\/dc16-S005","article-title":"Classification and Diagnosis of Diabetes","volume":"39","author":"Care","year":"2016","journal-title":"Am. Diabetes Assoc. Diabetes Care"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Silva, A.P., Mendes, F., Carias, E., Gon\u00e7alves, R.B., Fragoso, A., Dias, C., Tavares, N., Caf\u00e9, H.M., Santos, N., and Rato, F. (2019). Plasmatic Klotho and FGF23 levels as biomarkers of CKD-associated cardiac disease in type 2 diabetic patients. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20071536"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"247649","DOI":"10.1155\/2013\/247649","article-title":"What is the role of apelin regarding cardiovascular risk and progression of renal disease in type 2 diabetic patients with diabetic nephropathy?","volume":"2013","author":"Silva","year":"2013","journal-title":"BioMed Res. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"107476","DOI":"10.1016\/j.jdiacomp.2019.107476","article-title":"FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease","volume":"34","author":"Ribeiro","year":"2020","journal-title":"J. Diabetes Complicat."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.kint.2017.04.006","article-title":"Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: What\u2019s changed and why it matters","volume":"92","author":"Ketteler","year":"2017","journal-title":"Kidney Int."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e007146","DOI":"10.1161\/CIRCIMAGING.117.007146","article-title":"Computed Tomography Aortic Valve Calcium Scoring in Patients with Aortic Stenosis","volume":"11","author":"Pawade","year":"2018","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1093\/ckj\/sfv073","article-title":"Fibroblast growth factor 23 and parathyroid hormone predict extent of aortic valve calcifications in patients with mild to moderate chronic kidney disease","volume":"8","author":"Gorini","year":"2015","journal-title":"Clin. Kidney J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1136\/hrt.60.4.299","article-title":"Percutaneous balloon dilatation of the mitral valve: An analysis of echocardiographic variables related to outcome and the mechanism of dilatation","volume":"60","author":"Wilkins","year":"1988","journal-title":"Br. Heart J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1053\/j.ackd.2017.12.001","article-title":"Magnesium as a Calcification Inhibitor","volume":"25","author":"Massy","year":"2018","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_35","first-page":"gfaa222","article-title":"Magnesium to prevent kidney disease-associated vascular calcification: Crystal clear?","volume":"29","author":"Vervloet","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1016\/j.ekir.2021.05.012","article-title":"Phosphate Balance and CKD-Mineral Bone Disease","volume":"6","author":"Sprague","year":"2021","journal-title":"Kidney Int. Rep."},{"key":"ref_37","first-page":"370","article-title":"Hyperphosphatemia and Cardiovascular Disease","volume":"9","author":"Zhou","year":"2021","journal-title":"Front. Cell Dev. Biol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Cozzolino, M., Ciceri, P., Galassi, A., Mangano, M., Carugo, S., Capelli, I., and Cianciolo, G. (2019). The Key Role of Phosphate on Vascular Calcification. Toxins, 11.","DOI":"10.3390\/toxins11040213"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.xkme.2020.10.010","article-title":"Serum Magnesium and Cardiovascular Outcomes and Mortality in CKD: The Chronic Renal Insufficiency Cohort (CRIC)","volume":"3","author":"Negrea","year":"2021","journal-title":"Kidney Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1093\/ndt\/13.8.2037","article-title":"Cardiac valve calcification in haemodialysis patients: Role of calcium-phosphate metabolism","volume":"13","author":"Ribeiro","year":"1998","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0002-9149(83)80087-3","article-title":"Calcium phosphorus metabolism in dialysis patients with and without mitral anular calcium: Analysis of 30 patients","volume":"51","author":"Nestico","year":"1983","journal-title":"Am. J. Cardiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jacc.2010.11.073","article-title":"Association of serum phosphate levels with aortic valve sclerosis and annular calcification: The cardiovascular health study","volume":"58","author":"Linefsky","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1681\/ASN.2008040349","article-title":"Association of serum phosphate with vascular and valvular calcification in moderate CKD","volume":"20","author":"Adeney","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.atherosclerosis.2018.03.035","article-title":"Serum magnesium, phosphorus, and calcium levels and subclinical calcific aortic valve disease: A population-based study","volume":"273","author":"Hisamatsu","year":"2018","journal-title":"Atherosclerosis"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Ter Braake, A.D., Govers, L.P., Peeters, M.J., van Zuilen, A.D., Wetzels, J.F., Blankenstijn, P.J., Hoenderop, J.G., de Baaij, J.H., van den Brand, J.A., and MASTERPLAN Study Group (2021). Low plasma magnesium concentration and future abdominal aortic calcifications in moderate chronic kidney disease. BMC Nephrol., 22.","DOI":"10.1186\/s12882-021-02267-4"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1093\/ckj\/sfu003","article-title":"Magnesium and FGF-23 are independent predictors of pulse pressure in pre-dialysis diabetic chronic kidney disease patients","volume":"7","author":"Fragoso","year":"2014","journal-title":"Clin. Kidney J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"308190","DOI":"10.1155\/2015\/308190","article-title":"Low Magnesium Levels and FGF-23 Dysregulation Predict Mitral Valve Calcification as well as Intima Media Thickness in Predialysis Diabetic Patients","volume":"2015","author":"Silva","year":"2015","journal-title":"Int. J. Endocrinol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1038\/ki.2015.165","article-title":"Magnesium modifies the association between serum phosphate and the risk of progression to end-stage kidney disease in patients with non-diabetic chronic kidney disease","volume":"88","author":"Sakaguchi","year":"2015","journal-title":"Kidney Int."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1161\/ATVBAHA.118.312191","article-title":"Potential Role of H-Ferritin in Mitigating Valvular Mineralization","volume":"39","author":"Sikura","year":"2019","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"4961","DOI":"10.1038\/s41598-018-23353-y","article-title":"Ucma\/GRP inhibits phosphate-induced vascular smooth muscle cell calcification via SMAD-dependent BMP signaling","volume":"8","author":"Willems","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2147\/JIR.S136742","article-title":"Magnesium deficiency and increased inflammation: Current perspectives","volume":"11","author":"Nielsen","year":"2018","journal-title":"J. Inflamm. Res."},{"key":"ref_52","first-page":"21","article-title":"Is circulating gla-rich protein linked with coronary calcium and cardiovascular pathology in patients with atrial fibrillation or heart failure? A pilot study","volume":"53","author":"Vankova","year":"2021","journal-title":"Scr. Sci. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"4274","DOI":"10.18632\/aging.102046","article-title":"The interplay between mineral metabolism, vascular calcification and inflammation in Chronic Kidney Disease (CKD): Challenging old concepts with new facts","volume":"11","author":"Viegas","year":"2019","journal-title":"Aging"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1681\/ASN.2018111150","article-title":"A Randomized Trial of Magnesium Oxide and Oral Carbon Adsorbent for Coronary Artery Calcification in Predialysis CKD","volume":"30","author":"Sakaguchi","year":"2019","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1681\/ASN.2006080936","article-title":"Fibroblast growth factor 23 (FGF23) predicts progression of chronic kidney disease: The Mild to Moderate Kidney Disease (MMKD) Study","volume":"18","author":"Fliser","year":"2007","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1159\/000440984","article-title":"Elevated Fibroblast Growth Factor 23 Concentration: Prediction of Mortality among Chronic Kidney Disease Patients","volume":"6","author":"Chathoth","year":"2015","journal-title":"Cardiorenal. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1007\/s00198-011-1838-0","article-title":"FGF23 is independently associated with vascular calcification but not bone mineral density in patients at various CKD stages","volume":"23","author":"Desjardins","year":"2012","journal-title":"Osteoporos. Int."},{"key":"ref_58","first-page":"17","article-title":"Fibroblast growth factor 23 predicts coronary calcification and poor prognosis in patients with chronic kidney disease stages 3-5D","volume":"45","author":"Zhang","year":"2015","journal-title":"Ann. Clin. Lab. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1681\/ASN.2017121334","article-title":"Fibroblast Growth Factor-23 and Risks of Cardiovascular and Noncardiovascular Diseases: A Meta-Analysis","volume":"29","author":"Marthi","year":"2018","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1093\/ndt\/gfu063","article-title":"Fibroblast growth factor 23 (FGF23) and early chronic kidney disease in the elderly","volume":"29","author":"Chudek","year":"2014","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Chu, C., Elitok, S., Zeng, S., Xiong, Y., Hocher, C.F., Hasan, A.A., Kr\u00e4mer, B.K., and Hocher, B. (2021). C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival. BMC Nephrol., 22.","DOI":"10.1186\/s12882-021-02329-7"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3639","DOI":"10.1681\/ASN.2016121350","article-title":"C-Terminal Fibroblast Growth Factor 23, Iron Deficiency, and Mortality in Renal Transplant Recipients","volume":"28","author":"Eisenga","year":"2017","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"van Breda, F., Emans, M.E., van der Putten, K., Braam, B., van Ittersum, F.J., Kraaijenhagen, R.J., de Borst, M.H., Vervloet, M., and Gaillard, C.A. (2015). Relation between Red Cell Distribution Width and Fibroblast Growth Factor 23 Cleaving in Patients with Chronic Kidney Disease and Heart Failure. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0128994"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"7899","DOI":"10.18632\/aging.102297","article-title":"Fibroblast growth factor 23 expression in human calcified vascular tissues","volume":"11","author":"Ferri","year":"2019","journal-title":"Aging"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/2\/496\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:19:44Z","timestamp":1760134784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/2\/496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,15]]},"references-count":64,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["diagnostics12020496"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12020496","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,15]]}}}