Objective To explore the correlation between serum fibroblast growth factor-23 (FGF23), Klotho protein levels and cardiac valve calcification (CVC) in patients with maintenance hemodialysis (MHD).

Methods A total of 169 MHD patients in the Blood Purification Center of Jinshan Hospital, Fudan University from January 2022 to January 2023 were selected. The patients' CVC status was examined by color Doppler echocardiography.

Results There were 111 CVC cases, accounting for 65.68%. Compared with the non-CVC group, the CVC group had significantly higher levels of FGF23, β2-microglobulin, brain natriuretic peptide (BNP), age, and the proportion of male, while significantly lower levels of Klotho, predialysis creatinine, hemoglobin, plasma albumin and iPTH (P < 0.05). Pearson/Spearman correlation coefficient analysis showed that FGF23, age, β2-microglobulin and BNP were significantly positively correlated with CVC (r＝0.20, 0.41, 0.15, 0.28, 0.12), while Klotho, predialysis creatinine, hemoglobin, plasma albumin and iPTH were significantly negatively correlated with CVC (r＝-0.16, -0.17, -0.16, -0.17, -0.16). Unconditioned binary logistic regression analysis showed that FGF23, Klotho, age and β2-microglobulin were independent risk factors for CVC in MHD patients.

Conclusions MHD patients are prone to CVC. Serum FGF23 protein level is significantly positively correlated with CVC, while Klotho protein level is significantly negatively correlated with CVC. FGF23, Klotho, age and β2-microglobulin are independent risk factors for CVC in MHD patients.