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Fibroblast growth factor 23 (FGF23) and early chronic kidney disease in the elderly.
Nephrol Dial Transplant. 2014 Sep; 29(9):1757-63.ND

Abstract

BACKGROUND

Better biomarkers of CKD reflecting responses to decreased glomerular filtration rate (GFR) are needed. We determined the value of estimated GFR (eGFR) as a threshold for the increase of plasma cFGF23 (C-terminal) and intact fibroblast growth factor-23 (iFGF23) (intact) concentrations in the course of chronic kidney disease (CKD) and compared this eGFR value with values related to increased serum intact parathyroid hormone (iPTH) or phosphorus concentrations in an elderly population.

METHODS

We measured plasma iFGF23, cFGF23, serum phosphorus, calcium, albumin, creatinine, urea, cystatin C, iPTH and vitamin 25-OH-D3 in 3780 population-based study participants aged ≥ 65 years.

RESULTS

Serum phosphorus concentrations hardly increased until mean eGFR reached 47.3 ± 4.7 mL/min/1.73 m(2) but then increased exponentially. Similarly, both iPTH and iFGF23 increased slightly in early CKD but then increased exponentially when eGFR reached 55.0 ± 4.2 mL/min/1.73 m(2) for iPTH and 51.6 ± 5.7 mL/min/1.73 m(2) for iFGF23. The departure point for exponential increases in cFGF23 preceded those for iPTH and iFGF23 and occurred at a mean eGFR of 57.7 ± 7.8 mL/min/1.73 m(2). The prevalence of increased iFGF23 occurred at a remarkably higher eGFR value than that of cFGF23 across the CKD stages.

CONCLUSIONS

The increase in cFGF23 preceded both the increase in iPTH and iFGF23 as eGFR declined. Increased plasma iFGF23 level did not precede the rise in serum iPTH concentrations and did not occur before stage-3 CKD in elderly persons. However, cFGF23 was not an early marker of CKD in the elderly subjects.

Authors+Show Affiliations

Pathophysiology Unit, Department of Pathophysiology, Medical University of Silesia, Katowice, Poland Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland.Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical University of Silesia, Katowice, Poland.Division of Statistics in Sosnowiec, Medical University of Silesia, Katowice, Poland.Pathophysiology Unit, Department of Pathophysiology, Medical University of Silesia, Katowice, Poland.International Institute of Molecular and Cell Biology, Warsaw, Poland.Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical University of Silesia, Katowice, Poland.Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24729016

Citation

Chudek, Jerzy, et al. "Fibroblast Growth Factor 23 (FGF23) and Early Chronic Kidney Disease in the Elderly." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 29, no. 9, 2014, pp. 1757-63.
Chudek J, Kocełak P, Owczarek A, et al. Fibroblast growth factor 23 (FGF23) and early chronic kidney disease in the elderly. Nephrol Dial Transplant. 2014;29(9):1757-63.
Chudek, J., Kocełak, P., Owczarek, A., Bożentowicz-Wikarek, M., Mossakowska, M., Olszanecka-Glinianowicz, M., & Wiecek, A. (2014). Fibroblast growth factor 23 (FGF23) and early chronic kidney disease in the elderly. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 29(9), 1757-63. https://doi.org/10.1093/ndt/gfu063
Chudek J, et al. Fibroblast Growth Factor 23 (FGF23) and Early Chronic Kidney Disease in the Elderly. Nephrol Dial Transplant. 2014;29(9):1757-63. PubMed PMID: 24729016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fibroblast growth factor 23 (FGF23) and early chronic kidney disease in the elderly. AU - Chudek,Jerzy, AU - Kocełak,Piotr, AU - Owczarek,Aleksander, AU - Bożentowicz-Wikarek,Maria, AU - Mossakowska,Małgorzata, AU - Olszanecka-Glinianowicz,Magdalena, AU - Wiecek,Andrzej, Y1 - 2014/04/11/ PY - 2014/4/15/entrez PY - 2014/4/15/pubmed PY - 2015/6/13/medline KW - chronic kidney disease KW - elderly population KW - fibroblast growth factor 23 SP - 1757 EP - 63 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 29 IS - 9 N2 - BACKGROUND: Better biomarkers of CKD reflecting responses to decreased glomerular filtration rate (GFR) are needed. We determined the value of estimated GFR (eGFR) as a threshold for the increase of plasma cFGF23 (C-terminal) and intact fibroblast growth factor-23 (iFGF23) (intact) concentrations in the course of chronic kidney disease (CKD) and compared this eGFR value with values related to increased serum intact parathyroid hormone (iPTH) or phosphorus concentrations in an elderly population. METHODS: We measured plasma iFGF23, cFGF23, serum phosphorus, calcium, albumin, creatinine, urea, cystatin C, iPTH and vitamin 25-OH-D3 in 3780 population-based study participants aged ≥ 65 years. RESULTS: Serum phosphorus concentrations hardly increased until mean eGFR reached 47.3 ± 4.7 mL/min/1.73 m(2) but then increased exponentially. Similarly, both iPTH and iFGF23 increased slightly in early CKD but then increased exponentially when eGFR reached 55.0 ± 4.2 mL/min/1.73 m(2) for iPTH and 51.6 ± 5.7 mL/min/1.73 m(2) for iFGF23. The departure point for exponential increases in cFGF23 preceded those for iPTH and iFGF23 and occurred at a mean eGFR of 57.7 ± 7.8 mL/min/1.73 m(2). The prevalence of increased iFGF23 occurred at a remarkably higher eGFR value than that of cFGF23 across the CKD stages. CONCLUSIONS: The increase in cFGF23 preceded both the increase in iPTH and iFGF23 as eGFR declined. Increased plasma iFGF23 level did not precede the rise in serum iPTH concentrations and did not occur before stage-3 CKD in elderly persons. However, cFGF23 was not an early marker of CKD in the elderly subjects. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/24729016/Fibroblast_growth_factor_23__FGF23__and_early_chronic_kidney_disease_in_the_elderly_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfu063 DB - PRIME DP - Unbound Medicine ER -