Fibroblast growth factor 23 (FGF23) level is associated with ultrafiltration rate in patients on hemodialysis

• Published in: Heart and vessels 2021-03, Vol.36 (3), p.414-423
• Main Authors: Nishizawa, Yoko, Hosoda, Yumi, Horimoto, Ai, Omae, Kiyotsugu, Ito, Kyoko, Higuchi, Chieko, Sakura, Hiroshi, Nitta, Kosaku, Ogawa, Tetsuya
• Format: Article
• Language: English
• Subjects: Alkaline phosphatase; Biomedical Engineering and Bioengineering; Blood pressure; Bone diseases; Calcification; Calcification (ectopic); Calcium; Calcium (blood); Cardiac Surgery; Cardiology; Cardiovascular diseases; Dialysis; Fibroblast growth factor 23; Fibroblasts; Growth factors; Heart; Heart diseases; Hemodialysis; Hypertrophy; Kidney diseases; Medicine; Medicine & Public Health; Mortality; Multivariate analysis; Original; Original Article; Parathyroid; Parathyroid hormone; Proximal tubules; Reabsorption; Regression analysis; Septum; Ultrafiltration; Urea; Ureas; Vascular Surgery; Ventricle; Vitamin D
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-020-01704-y

Fibroblast growth factor 23 (FGF23) is a bone-derived hormone that regulates renal phosphate reabsorption and vitamin D synthesis in renal proximal tubules. High circulating FGF23 levels are associated with increased mortality in patients with chronic kidney disease and those on dialysis. Current data also suggest higher circulating levels of FGF23 are associated with cardiovascular mortality, vascular calcification, and left ventricular hypertrophy; however, evidence on the role of FGF23 in patients on dialysis is incomplete, and some of the data, especially those on cardiovascular disease (CVD), are controversial. This study aimed to evaluate factors associated with FGF23 in hemodialysis patients with or without CVD. Randomly selected 76 patients on maintenance hemodialysis at a single hemodialysis center were enrolled. After the exclusion of eight patients with extremely outlying FGF23 levels, 68 patients, including 48 males and 46 patients with a CVD history, were included in the study. The mean age was 64.4 ± 12.1 years, and the mean dialysis duration was 12.7 ± 7.1 years. Dialysis duration, time-averaged concentration of urea (TAC-urea), ultrafiltration rate (UFR), blood pressure during hemodialysis session, laboratory data, and echocardiographic parameters including interventricular septum thickness (IVST), left ventricular mass indices (LVMI), and ejection fraction were included in univariate and multivariate analyses. The median lgFGF23 levels in the overall cohort and in those with and without CVD were 2.14 (interquartile range, IQR − 0.43 to − 4.23), 2.01 (− 0.52 to 4.12), and 2.59 (0.07 to 4.32), respectively, and there was no difference between the patients with and without CVD ( p  = 0.14). The univariate analysis revealed that FGF23 was significantly associated with age ( r  =  − 0.12, p