Fibroblast growth factor 23: a possible cause of left ventricular hypertrophy in hemodialysis patients.
BACKGROUND
Left ventricular hypertrophy (LVH) is a common cardiovascular disorder and an independent risk factor for cardiovascular death in dialysis patients. Hyperphosphatemia is associated with LVH. Previous studies have shown that fibroblast growth factor 23 (FGF23), which has an important role in phosphate metabolism, is elevated in chronic hemodialysis patients.


OBJECTIVE
The aim of this study is to determine the association of FGF23 and LVH and the prognostic value of FGF23 in chronic hemodialysis patients.


METHODS
One hundred twenty-four end-stage renal disease patients were evaluated for LVH by echocardiography. Serum FGF23 levels were measured using a commercial enzyme-linked immunosorbent assay kit.


RESULTS
Patients with LVH were more likely to have poor urea clearance (Kt/V), higher systolic blood pressure, and comorbidity of diabetes mellitus and coronary artery disease. LVH was also associated with higher levels of FGF23. Multivariate analysis indicated that FGF23 level, systolic blood pressure, and comorbidity of diabetes mellitus and coronary artery disease remained correlated with LVH. This suggested that serum FGF23 level is independently associated with LVH in our hemodialysis patients. Cox analysis indicated no significant difference in risk of death for patients with elevated levels of FGF23.


CONCLUSIONS
LVH has a high prevalence in hemodialysis patients, and FGF23 is independently associated with LVH but is not a predictor for short-term prognosis (2-year follow-up).
Hsu
Heng Jung
HJ
School of Medicine, Chang Gung University, and Department of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Wu
Mai-Szu
MS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D055815:Young Adult
C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23