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. Author manuscript; available in PMC: 2016 Aug 1.
Published in final edited form as: Am J Kidney Dis. 2015 Feb 26;66(2):196–205. doi: 10.1053/j.ajkd.2014.12.016

Figure 2. Anemia, bone, and mineral axis factors implicated in development of heart failure.

Figure 2

Decreases in hemoglobin, erythropoietin, calcium, vitamin D, iron, and fetuin-A, as well as increases in serum phosphorous, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF-23), may induce myocyte hypertrophy, mechanical dysfunction, and myocardial fibrosis while simultaneously contributing to endothelial dysfunction, vascular stiffness, and vascular calcification. These changes ultimately induce systolic and diastolic function, salt and water retention, and the clinical syndrome of heart failure.