Determinants of Fibroblast Growth Factor-23 and Parathyroid Hormone Variability in Dialysis Patients
2013 (English)In: American Journal of Nephrology, ISSN 0250-8095, E-ISSN 1421-9670, Vol. 37, no 5, 462-471 p.Article in journal (Refereed) Published
Background/Aims: Treatment strategies for abnormal mineral metabolism in chronic kidney disease are largely based on achieving target ranges of biomarkers that vary considerably over time, yet determinants of their variability are poorly defined. Methods: Observational study including 162 patients of three dialysis cohorts (peritoneal dialysis, n = 78; hemodialysis, n = 49; hemodiafiltration, n = 35). Clinical and biochemical determinants of parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF23) variability were analyzed in the peritoneal dialysis cohort. All cohorts were used for comparison of PTH and FGF23 intra-subject variability (intra-class correlation), and their intra-subject variability in different modes of dialysis was explored. Results: High PTH variability was independently associated with lower 25-hydroxyvitamin D concentration and factors of lipid and glucose metabolism, whereas high FGF23 variability was mainly associated with lower baseline serum phosphorous. These results were consistent in multivariate and sensitivity analyses. The intra-subject variability of FGF23 was lower than for PTH irrespective of dialysis mode. Conclusions: Baseline vitamin D status and serum phosphorous are independent determinants of the longitudinal variation in PTH and FGF23, respectively. The clinical utility of FGF23 measurement remains unknown, yet it appears favorable based on its greater temporal stability than PTH in dialysis patients.
Place, publisher, year, edition, pages
Karger , 2013. Vol. 37, no 5, 462-471 p.
Fibroblast growth factor-23, FGF23, Parathyroid hormone, PTH, Chronic kidney disease
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-94333DOI: 10.1159/000350537ISI: 000318703900008OAI: oai:DiVA.org:liu-94333DiVA: diva2:631953
Funding Agencies|China Scholarship Council||Amgen the Swedish Foundation for Strategic Research|MIMICK 2|Swedish Research Council|K2012-55P-22137-01-06|Swedish Kidney Foundation||Karolinska Institutet||Baxter Healthcare Corporation||2013-06-242013-06-242013-12-02