Fibroblast growth factor 23 in patients undergoing peritoneal dialysis

Tamara Isakova, Huiliang Xie, Allison Barchi-Chung, Gabriela Varga, Nicole Sowden, Jessica Houston, Patricia Wahl, Andrew Lundquist, Michael Epstein, Kelsey Smith, Gabriel Contreras, Luis Ortega, Oliver Lenz, Patricia Briones, Phyllis Egbert, T. Alp Ikizler, Harald Jueppner, Myles Wolf*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


Background and objectives Fibroblast growth factor 23 (FGF23) is an independent risk factor for mortality in patients with ESRD. Before FGF23 testing can be integrated into clinical practice of ESRD, further understanding of its determinants is needed. Design, setting, participants, & measurements In a study of 67 adults undergoing peritoneal dialysis, we tested the hypothesis that longer dialysis vintage and lower residual renal function and renal phosphate clearance are associated with higher FGF23. We also compared the monthly variability of FGF23 versus parathyroid hormone (PTH) and serum phosphate. Results In unadjusted analyses, FGF23 correlated with serum phosphate (r=0.66, P >0.001), residual renal function (r=0.37, P<0.002), dialysis vintage (r=-0.31, P=0.01), and renal phosphate clearance (r=-0.38, P=0.008). In adjusted analyses, absence of residual renal function and greater dialysis vintage associated with higher FGF23, independent of demographics, laboratory values, peritoneal dialysis modality and adequacy, and treatment with vitamin D analogs and phosphate binders. Urinary and dialysate FGF23 clearances were minimal. In three serial monthly measurements, within-subject variability accounted for only 10% of total FGF23 variability compared with 50% for PTH and 60% for serum phosphate.

Original languageEnglish (US)
Pages (from-to)2688-2695
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Issue number11
StatePublished - Nov 1 2011

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation
  • Epidemiology


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