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Fibroblast growth factor-23 and early decrements in kidney function: the Heart and Soul Study.
Nephrol Dial Transplant. 2010 Mar; 25(3):993-7.ND

Abstract

BACKGROUND

Fibroblast growth factor-23 (FGF-23) is associated with mortality in dialysis patients, and concentrations are elevated in moderate chronic kidney disease (CKD). The threshold of CKD or albuminuria at which FGF-23 begins to change is unknown.

METHODS

In 792 outpatients with stable cardiovascular disease (CVD) and normal kidney function to moderate CKD, we evaluate the associations of estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) with plasma FGF-23 concentrations.

RESULTS

Compared to participants with eGFR >or=90 ml/min/1.73 m(2), mean FGF-23 concentrations were 7.8 RU/ml higher (4.3-11.5, P = 0.01) in those with eGFR 60-89 ml/min/1.73 m(2) in models adjusted for age, sex, race, ACR, blood pressure, diabetes and body mass index. More advanced decrements in eGFR were associated with much higher FGF-23 concentrations. In spline analysis, the slope of change in FGF-23 concentration was evident at eGFR <90 ml/min/1.73 m(2). Compared to participants with ACR <30 mg/g, mean FGF-23 concentrations were 18.4 RU/ml higher (9.3-29.2, P < 0.001) in those with ACR 30-299 mg/g in models adjusted for identical covariates plus eGFR and much higher in individuals with ACR >or=300 mg/g. Spline analysis demonstrated a linear relationship of ACR with FGF-23, independent of eGFR, even among persons with ACR <30 mg/g.

CONCLUSION

Modest decrements in eGFR or elevations in albuminuria are each independently associated with higher FGF-23 concentrations in outpatients with stable CVD.

Authors+Show Affiliations

Division of Nephrology, Department of Medicine, University of California San Diego, San Diego, CA, USA. joeix@ucsd.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

20037168

Citation

Ix, Joachim H., et al. "Fibroblast Growth Factor-23 and Early Decrements in Kidney Function: the Heart and Soul Study." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 25, no. 3, 2010, pp. 993-7.
Ix JH, Shlipak MG, Wassel CL, et al. Fibroblast growth factor-23 and early decrements in kidney function: the Heart and Soul Study. Nephrol Dial Transplant. 2010;25(3):993-7.
Ix, J. H., Shlipak, M. G., Wassel, C. L., & Whooley, M. A. (2010). Fibroblast growth factor-23 and early decrements in kidney function: the Heart and Soul Study. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 25(3), 993-7. https://doi.org/10.1093/ndt/gfp699
Ix JH, et al. Fibroblast Growth Factor-23 and Early Decrements in Kidney Function: the Heart and Soul Study. Nephrol Dial Transplant. 2010;25(3):993-7. PubMed PMID: 20037168.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fibroblast growth factor-23 and early decrements in kidney function: the Heart and Soul Study. AU - Ix,Joachim H, AU - Shlipak,Michael G, AU - Wassel,Christina L, AU - Whooley,Mary A, Y1 - 2009/12/27/ PY - 2009/12/29/entrez PY - 2009/12/29/pubmed PY - 2010/6/4/medline SP - 993 EP - 7 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 25 IS - 3 N2 - BACKGROUND: Fibroblast growth factor-23 (FGF-23) is associated with mortality in dialysis patients, and concentrations are elevated in moderate chronic kidney disease (CKD). The threshold of CKD or albuminuria at which FGF-23 begins to change is unknown. METHODS: In 792 outpatients with stable cardiovascular disease (CVD) and normal kidney function to moderate CKD, we evaluate the associations of estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) with plasma FGF-23 concentrations. RESULTS: Compared to participants with eGFR >or=90 ml/min/1.73 m(2), mean FGF-23 concentrations were 7.8 RU/ml higher (4.3-11.5, P = 0.01) in those with eGFR 60-89 ml/min/1.73 m(2) in models adjusted for age, sex, race, ACR, blood pressure, diabetes and body mass index. More advanced decrements in eGFR were associated with much higher FGF-23 concentrations. In spline analysis, the slope of change in FGF-23 concentration was evident at eGFR <90 ml/min/1.73 m(2). Compared to participants with ACR <30 mg/g, mean FGF-23 concentrations were 18.4 RU/ml higher (9.3-29.2, P < 0.001) in those with ACR 30-299 mg/g in models adjusted for identical covariates plus eGFR and much higher in individuals with ACR >or=300 mg/g. Spline analysis demonstrated a linear relationship of ACR with FGF-23, independent of eGFR, even among persons with ACR <30 mg/g. CONCLUSION: Modest decrements in eGFR or elevations in albuminuria are each independently associated with higher FGF-23 concentrations in outpatients with stable CVD. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/20037168/Fibroblast_growth_factor_23_and_early_decrements_in_kidney_function:_the_Heart_and_Soul_Study_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfp699 DB - PRIME DP - Unbound Medicine ER -