title: FGF-23 is associated with cardiac troponin T and mortality in hemodialysis patients.
abstract: Fibroblast growth factor 23 (FGF-23) is elevated in patients with end-stage kidney disease and has been linked with mortality, vascular calcification, markers of bone turnover, and left ventricular hypertrophy. In this cohort study, we determined the correlates of FGF-23 (including cardiac troponin T [cTNT]) and determined its association with mortality over 3.5 years of follow-up in 103 prevalent hemodialysis patients. Mean age was 61.2 (15.5) and the mean dialysis vintage was 4.19 years (4.6). The median (interquartile range) FGF-23 was 1259 (491, 2885) RU/mL. Independent predictors (estimate standard error) of log-transformed FGF-23 concentrations included phosphorus (0.75 [0.237], P = 0.002) and cardiac troponin T (1.04 [0.41], P = 0.01). There were 57 deaths. In the fully adjusted model, the significant predictors of mortality included age and albumin. The independent association between FGF-23 and cTNT is a novel finding. Whether this relationship supports the possibility that a downstream effect of dysregulated phosphorous homeostasis may be enhanced cardiac remodeling requires further study.
authors.affiliation: Department of Medicine, Queen's University, Kingston, Ontario, Canada. holdenr@kgh.kari.net
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Holden
authors.forename: David
authors.initials: D
authors.lastname: Beseau
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Booth
authors.forename: Michael A
authors.initials: MA
authors.lastname: Adams
authors.forename: Jocelyn S
authors.initials: JS
authors.lastname: Garland
authors.forename: Ross A
authors.initials: RA
authors.lastname: Morton
authors.forename: Christine P
authors.initials: CP
authors.lastname: Collier
authors.forename: Robert N
authors.initials: RN
authors.lastname: Foley
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000378:metabolism; D006435:Renal Dialysis / Q000401:mortality*; D020107:Troponin T / Q000097:blood*
chemical_list: C000717427:FGF23 protein, human; D020107:Troponin T; D010758:Phosphorus; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23