Relationship between plasma fibroblast growth factor-23 concentration and bone mineralization in children with renal failure on peritoneal dialysis.
BACKGROUND
Fibroblast growth factor (FGF)-23 is produced in bone, and circulating levels are markedly elevated in patients with end-stage kidney disease, but the relationship between plasma levels of FGF-23 and bone histology in dialysis patients with secondary hyperparathyroidism is unknown.


OBJECTIVE
The aim of the study was to evaluate the correlation between plasma levels of FGF-23 and bone histology in pediatric patients with end-stage kidney disease who display biochemical evidence of secondary hyperparathyroidism.


METHODS
We performed a cross-sectional analysis of the relationship between plasma FGF-23 levels and bone histomorphometry.


METHODS
The study was conducted in a referral center.


METHODS
Participants consisted of forty-nine pediatric patients who were treated with maintenance peritoneal dialysis and who had serum PTH levels (1st generation Nichols assay) greater than 400 pg/ml.


METHODS
There were no interventions.


METHODS
Plasma FGF-23 levels and bone histomorphometry were measured.


RESULTS
No correlation existed between values of PTH and FGF-23. Bone formation rates correlated with PTH (r = 0.44; P < 0.01), but not with FGF-23. Higher FGF-23 concentrations were associated with decreased osteoid thickness (r = -0.49; P < 0.01) and shorter osteoid maturation time (r = -0.48; P < 0.01).


CONCLUSIONS
High levels of FGF-23 are associated with improved indices of skeletal mineralization in dialyzed pediatric patients with high turnover renal osteodystrophy. Together with other biomarkers, FGF-23 measurements may indicate skeletal mineralization status in this patient population.
Wesseling-Perry
Katherine
K
Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, A2-383 MDCC, 10833 LeConte Boulevard, Los Angeles, California 90095, USA. kwesseling@mednet.ucla.edu
Pereira
Renata C
RC
Wang
Hejing
H
Elashoff
Robert M
RM
Sahney
Shobha
S
Gales
Barbara
B
Jüppner
Harald
H
Salusky
Isidro B
IB
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology; D002113:Calcification, Physiologic / Q000502:physiology; D002118:Calcium / Q000097:blood; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010530:Peritoneal Dialysis; D014807:Vitamin D / Q000097:blood; D055815:Young Adult
D015415:Biomarkers; C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002118:Calcium