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J Parathyr Dis. 2016;4(1): 7-10.
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Correlation of fibroblast growth factor 23 in chronic kidney disease patients with biochemical parameters and outcomes

Anand Yuvaraj 1, Georgi Abraham 1,2*, Madhusudan Vijayan 1, Jayaraju Jayapal 1, Saranya Kulanthaipandian 1, Sanjeev Nair 1

1 Department of Nephrology, Madras Medical Mission, Chennai, India.
2 Department of Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India.
*Corresponding Author: *Corresponding author: Georgi Abraham, , Email: abraham_georgi@yahoo.com

Abstract

Introduction: Fibroblast growth factor 23 (FGF23) is a phosphatonin that increases the rate of urinary excretion of phosphate and  inhibits renal production of 1,25-dihydroxyvitamin D, hence helping to mitigate hyperphosphatemia in patients with chronic kidney disease (CKD).

Objectives: As there is a paucity of data in Indian CKD patients about the relevance of FGF23 levels, this study was undertaken at a tertiary care centre to correlate with various biochemical parameters and clinical outcome including mortality.

Patients and Methods: A cross-sectional study was done in 76 CKD patients, with 58 males, 18 females, mean age 58.21 ± 14.08 years, ranging from 25 to 91 years, in 36 chronic renal disease on dialysis (CKD-stage 5 dialysis; CKD-5D) and 40 non-dialysis chronic kidney disease (ND-CKD) patients.

Results: Intact FGF23 levels were higher in vegetarians than non-vegetarians, with mean FGF23 in vegetarians 378.72 ± 76.6 pg/ml, whereas in non-vegetarians 100.41 ± 41.3 pg/ml (P = 0.007). Higher values of intact FGF23 were associated with low EF (P = 0.008), high left ventricular (LV) mass index (g/m2) (P = 0.037) and high interventricular septal (IVS) thickness (mm) (P = 0.033).

Conclusion: Patients with low ejection fraction, higher interventricular septal thickness and higher LV mass index on 2-dimensional echocardiogram (2D-Echo) had a higher


Implication for health policy/practice/research/ medical education

In a cross-sectional study on 76 chronic renal failure patients, we found as association between high fibroblast growth factor 23 (FGF23) levels increased mortality in a group of chronic renal disease on dialysis and non-dialysis chronic kidney disease patients. Therapeutic strategies should address elevated FGF23 and hyperphosphataemia simultaneously to reduce cardiovascular morbidity and mortality.  

Please cite this paper as: Yuvaraj A, Abraham G, Vijayan M, Jayapal J, Kulanthaipandian S, Nair S. Correlation of fibroblast growth factor 23 in chronic kidney disease patients with biochemical parameters and outcomes. J Parathyr Dis. 2016;4(1):7-10.

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ePublished: 19 Dec 2015
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