Deviations from the expected relationship between serum FGF23 and other markers in children with CKD: a cross-sectional study

BMC Nephrology

Research Article

Daisy Liu¹  Vladimir Belostotsky¹  Brooke Wile²  Guido Filler³  Ana Catalina Alvarez-Elías⁴ 

[1] Department of Pediatrics, McMaster University, N6A 5W9, Hamilton, ON, Canada;Department of Pediatrics, Schulich School of Medicine & Dentistry, N6A 5W9, London, ON, Canada;Department of Pediatrics, Schulich School of Medicine & Dentistry, N6A 5W9, London, ON, Canada;Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, N5A 5A5, London, ON, Canada;Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, 5A 5A5, London, ON, Canada;Department of Pediatrics, Children’s Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, N6A 5W9, London, ON, Canada;Department of Pediatrics, Schulich School of Medicine & Dentistry, N6A 5W9, London, ON, Canada;Universidad Nacional Autónoma de México, 04510, Mexico City, Mexico;Laboratorio de Investigación en Nefrología, Hospital Infantil de México Federico Gómez, 067210, Mexico City, Mexico;

关键词: Chronic kidney disease;    Fibroblast growth factor 23;    pH;    Cystatin C (CysC);    GFR;    Parathyroid hormone (PTH);    Vitamin D metabolites;   

DOI  :  10.1186/s12882-017-0623-5

 received in 2016-12-05, accepted in 2017-06-19,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHigh levels of fibroblast growth factor-23 (FGF23) are associated with mortality. In chronic kidney disease (CKD), FGF23 levels rise as renal function declines. We analyzed the contribution of laboratory values to the variance of FGF23 levels in relationship to a curve of expected FGF23 levels for a given GFR.MethodsFollowing approval by the research ethics boards, we measured FGF23, CysC eGFR, creatinine, urea, albumin, calcium, phosphate, vitamin D metabolites, PTH, alkaline phosphatase, CRP, and venous gases in 141 pediatric CKD patients (45, 37, 32, 13 and 14 CKD stages I, II, III, IV, and V, respectively). Data were expressed as median (25th, 75th percentile).ResultsFGF23 correlated significantly with CysC, CysC eGFR, PTH, 1.25 (OH)2 vitamin D, phosphate, and pH. The correlation of the latter three remained significant in the multivariate analysis. We calculated a formula for the expected FGF23 value for a given level of eGFR which reads Y = 1295 * e-0.07247*X + 38.35. Deviation by more than 20% from the curve also depended on phosphate, 1.25 (OH)2 vitamin D and pH.ConclusionsOur data emphasize the importance of phosphate and 1.25 (OH)2 vitamin D levels. The impact of acidosis on FGF23 warrants further studies.

【 授权许可】

CC BY   
© The Author(s). 2017