FGF-23 associates with death, cardiovascular events, and initiation of chronic dialysis

Jessica Kendrick, Alfred K. Cheung, James S. Kaufman, Tom Greene, William L. Roberts, Gerard Smits, Michel Chonchol, Rex L. Jamison, Pamela Hartigan, James Kaufman, David S. Goldfarb, Stuart R. Warren, Peter D. Guarino, J. Michael Gaziano

Research output: Contribution to journalArticlepeer-review

392 Scopus citations

Abstract

Concentrations of the phosphate-regulating hormone fibroblast growth factor-23 (FGF-23) are elevated in patients with chronic kidney disease (CKD), but whether higher plasma FGF-23 concentrations associate with all-cause mortality, cardiovascular events, or initiation of chronic dialysis is not completely understood. Here, we measured FGF-23 concentration in stored plasma samples from 1099 patients with advanced CKD who participated in The Homocysteine in Kidney and End Stage Renal Disease study. Mean serum phosphorus concentration was 4.3 mg/dl, median FGF-23 concentration was 392 RU/ml, and mean GFR was 18 ml/min/1.73 m2. During a median follow-up of 2.9 yr, 453 (41%) patients died from any cause, 215 (20%) had a cardiovascular event, and 615 (56%) initiated chronic dialysis. Compared with the lowest quartile of FGF-23, each subsequent quartile associated with a progressively higher risk for death, adjusted for confounders (HR [95% CI] of 1.24 [0.91 to 1.69], 1.76 [1.28 to 2.44], and 2.17 [1.56 to 3.08] for the second through fourth quartiles, respectively). In addition, compared with the lowest quartile, the two highest quartiles of FGF-23 also associated with a significantly elevated risk for cardiovascular events and initiation of chronic dialysis. In conclusion, in advanced CKD, FGF-23 strongly and independently associates with all-cause mortality, cardiovascular events, and initiation of chronic dialysis. Copyright © 2011 by the American Society of Nephrology.
Original languageEnglish (US)
Pages (from-to)1913-1922
Number of pages10
JournalJournal of the American Society of Nephrology
Volume22
Issue number10
DOIs
StatePublished - Oct 1 2011
Externally publishedYes

Bibliographical note

Generated from Scopus record by KAUST IRTS on 2023-09-20

ASJC Scopus subject areas

  • Nephrology

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