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Early post-transplantation hypophosphatemia is associated with elevated FGF-23 levels.
Eur J Endocrinol. 2011 May; 164(5):839-47.EJ

Abstract

BACKGROUND

We examined the hypothesis that high FGF-23 levels early after transplantation contribute to the onset of hypophosphatemia, independently of parathyroid hormone (PTH) and other factors regulating phosphate metabolism.

METHODS

We measured serum phosphate levels (sPi), renal tubular reabsorption of Pi (TmPi/GFR), estimated GFR (eGFR), intact PTH (iPTH), calcitriol, intact (int) and C-terminal (Cter) FGF-23, dietary Pi intake and cumulative doses of glucocorticoids in 69 patients 12 days (95% confidence interval, 10-13) after renal transplantation.

RESULTS

Hypophosphatemia was observed in 43 (62%) of the patients 12 days after transplantation. Compared with non-hypophosphatemic subjects, their post-transplantation levels of intact and CterFGF-23 were higher (195 (108-288) vs 48 (40-64) ng/l, P<0.002 for intFGF-23; 205 (116-384) vs 81 (55-124) U/ml, P<0.002, for CterFGF-23). In all subjects, Cter and intFGF-23 correlated inversely with sPi (r=-0.35, P<0.003; -0.35, P<0.003, respectively), and TmPi/GFR (r=-0.50, P<0.001; -0.54, P<0.001, respectively). In multivariate models, sPi and TmPi/GFR were independently associated with FGF-23, iPTH and eGFR. Pre-transplant iPTH levels were significantly higher in patients developing hypophosphatemia after renal transplantation. Pre-transplant levels of FGF-23 were not associated with sPi at the time of transplantation.

CONCLUSION

In addition to PTH, elevated FGF-23 may contribute to hypophosphatemia during the early post-renal transplant period.

Authors+Show Affiliations

Department of Internal Medicine Service of Transplantation, University Hospitals, Geneva 14, Switzerland. andrea.trombetti@unige.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21335460

Citation

Trombetti, Andrea, et al. "Early Post-transplantation Hypophosphatemia Is Associated With Elevated FGF-23 Levels." European Journal of Endocrinology, vol. 164, no. 5, 2011, pp. 839-47.
Trombetti A, Richert L, Hadaya K, et al. Early post-transplantation hypophosphatemia is associated with elevated FGF-23 levels. Eur J Endocrinol. 2011;164(5):839-47.
Trombetti, A., Richert, L., Hadaya, K., Graf, J. D., Herrmann, F. R., Ferrari, S. L., Martin, P. Y., & Rizzoli, R. (2011). Early post-transplantation hypophosphatemia is associated with elevated FGF-23 levels. European Journal of Endocrinology, 164(5), 839-47. https://doi.org/10.1530/EJE-10-1150
Trombetti A, et al. Early Post-transplantation Hypophosphatemia Is Associated With Elevated FGF-23 Levels. Eur J Endocrinol. 2011;164(5):839-47. PubMed PMID: 21335460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early post-transplantation hypophosphatemia is associated with elevated FGF-23 levels. AU - Trombetti,Andrea, AU - Richert,Laura, AU - Hadaya,Karine, AU - Graf,Jean-Daniel, AU - Herrmann,François R, AU - Ferrari,Serge L, AU - Martin,Pierre-Yves, AU - Rizzoli,René, Y1 - 2011/02/18/ PY - 2011/2/22/entrez PY - 2011/2/22/pubmed PY - 2011/6/21/medline SP - 839 EP - 47 JF - European journal of endocrinology JO - Eur J Endocrinol VL - 164 IS - 5 N2 - BACKGROUND: We examined the hypothesis that high FGF-23 levels early after transplantation contribute to the onset of hypophosphatemia, independently of parathyroid hormone (PTH) and other factors regulating phosphate metabolism. METHODS: We measured serum phosphate levels (sPi), renal tubular reabsorption of Pi (TmPi/GFR), estimated GFR (eGFR), intact PTH (iPTH), calcitriol, intact (int) and C-terminal (Cter) FGF-23, dietary Pi intake and cumulative doses of glucocorticoids in 69 patients 12 days (95% confidence interval, 10-13) after renal transplantation. RESULTS: Hypophosphatemia was observed in 43 (62%) of the patients 12 days after transplantation. Compared with non-hypophosphatemic subjects, their post-transplantation levels of intact and CterFGF-23 were higher (195 (108-288) vs 48 (40-64) ng/l, P<0.002 for intFGF-23; 205 (116-384) vs 81 (55-124) U/ml, P<0.002, for CterFGF-23). In all subjects, Cter and intFGF-23 correlated inversely with sPi (r=-0.35, P<0.003; -0.35, P<0.003, respectively), and TmPi/GFR (r=-0.50, P<0.001; -0.54, P<0.001, respectively). In multivariate models, sPi and TmPi/GFR were independently associated with FGF-23, iPTH and eGFR. Pre-transplant iPTH levels were significantly higher in patients developing hypophosphatemia after renal transplantation. Pre-transplant levels of FGF-23 were not associated with sPi at the time of transplantation. CONCLUSION: In addition to PTH, elevated FGF-23 may contribute to hypophosphatemia during the early post-renal transplant period. SN - 1479-683X UR - https://www.unboundmedicine.com/medline/citation/21335460/Early_post_transplantation_hypophosphatemia_is_associated_with_elevated_FGF_23_levels_ L2 - https://eje.bioscientifica.com/doi/10.1530/EJE-10-1150 DB - PRIME DP - Unbound Medicine ER -