TY - JOUR
T1 - Fibroblast growth factor 23 in patients undergoing peritoneal dialysis
AU - Isakova, Tamara
AU - Xie, Huiliang
AU - Barchi-Chung, Allison
AU - Varga, Gabriela
AU - Sowden, Nicole
AU - Houston, Jessica
AU - Wahl, Patricia
AU - Lundquist, Andrew
AU - Epstein, Michael
AU - Smith, Kelsey
AU - Contreras, Gabriel
AU - Ortega, Luis
AU - Lenz, Oliver
AU - Briones, Patricia
AU - Egbert, Phyllis
AU - Ikizler, T. Alp
AU - Jueppner, Harald
AU - Wolf, Myles
PY - 2011/11/1
Y1 - 2011/11/1
N2 - 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.
AB - 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.
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U2 - 10.2215/CJN.04290511
DO - 10.2215/CJN.04290511
M3 - Article
C2 - 21903990
AN - SCOPUS:80655135433
SN - 1555-9041
VL - 6
SP - 2688
EP - 2695
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 11
ER -