Vascular calcification (VC), in which high serum phosphate plays a critical role, is one major problem in patients with chronic kidney disease. Clinical studies report that magnesium has a protective effect on VC. However, the studies regarding the impact of high serum magnesium on VC at a cellular level are few and require further investigation. Therefore, the present study explored the effect of magnesium on calcification induced by β‑glycerophosphate (BGP) in rat aortic vascular smooth muscle cells (RAVSMCs). In the present study, the addition of magnesium decreased calcium deposition, which was increased by BGP. Higher magnesium levels inhibited BGP‑induced alkaline phosphatase (ALP) activity and decreased the expression of core‑binding factor α‑1 (Cbfα1). In conclusion, higher magnesium levels prevented BGP‑induced calcification in RAVSMCs and inhibited the expression of Cbfα1 and ALP. Thus, magnesium is influencing the expression of Cbfα1 and ALP associated with VC and may have the potential to serve as a role for VC in clinical situations.

Introduction: This study was conducted to ensure the correlation between fibroblast growth factor 23 (FGF23) and death and cardiovascular events in hemodialysis patients. Methods: We conducted a literature search of PubMed database to April 2018 for relevant articles that reported the association between FGF23 and risk of all-cause mortality and cardiovascular disease (CVD) events. The meta-analysis was performed using the Revman 5.3 software. Results: A total of 7 articles were included, and all reported mortality in hemodialysis patients, and 3 reported cardiovascular events in hemodialysis patients. Since the current reagent can detect C-terminal FGF23 (cFGF23) and intact-FGF23 (iFGF23), we discuss the association between cFGF23 and iFGF23 and death and cardiovascular events in hemodialysis patients. The correlation between serum iFGF23 levels and death in hemodialysis patients: high levels of iFGF23 vs. low levels of iFGF23: RR 1.14, 95% CI (1.01–1.30), p = 0.04 (I² = 0%, p = 0.38). The correlation between serum C-terminal levels and death in hemodialysis patients: high levels of cFGF23 versus low levels of cFGF23: RR 1.39, 95% CI (1.21–1.59), p < 0.001 (I² = 2%, p = 0.38). The correlation of serum iFGF23 levels with cardiovascular events: high levels of iFGF23 versus low levels of iFGF23: RR 1.21, 95% CI (1.13–1.30), p < 0.001 (I² = 0%, p = 0.49). A paper has reported the association between cFGF23 and CVD events, so we did not conduct meta-analysis. Conclusions: Elevated serum FGF23 levels are positively associated with all-cause mortality and cardiovascular events in hemodialysis patients, with a 14 or 39% increase in all-cause mortality and a 21% increased risk of cardiovascular events.