title: Serum fibroblast growth factor-23 is associated with incident kidney disease.
abstract: Fibroblast growth factor-23 is a bone-derived hormone that increases urinary phosphate excretion and inhibits hydroxylation of 25-hydroxyvitamin D. Recent studies suggest that fibroblast growth factor-23 may be an early biomarker of CKD progression. However, its role in kidney function decline in the general population is unknown. We assessed the relationship between baseline (1990-1992) serum levels of intact fibroblast growth factor-23 and incident ESRD in 13,448 Atherosclerosis Risk in Communities study participants (56.1% women, 74.7% white) followed until December 31, 2010. At baseline, the mean age of participants was 56.9 years and the mean eGFR was 97 ml/min per 1.73 m(2). During a median follow-up of 19 years, 267 participants (2.0%) developed ESRD. After adjustment for demographic characteristics, baseline eGFR, traditional CKD risk factors, and markers of mineral metabolism, the highest fibroblast growth factor-23 quintile (>54.6 pg/ml) compared with the lowest quintile (<32.0 pg/ml) was associated with risk of developing ESRD (hazard ratio, 2.10; 95% confidence interval, 1.31 to 3.36; trend P<0.001). In a large, community-based study comprising a broad range of kidney function, higher baseline fibroblast growth factor-23 levels were associated with increased risk of incident ESRD independent of the baseline level of kidney function and a number of other risk factors.
authors: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; crebhol1@jhu.edu.
authors: Casey M
authors: CM
authors: Rebholz
authors: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Divisions of Nephrology and.
authors: Morgan E
authors: ME
authors: Grams
authors: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland;
authors: Josef
authors: J
authors: Coresh
authors: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland;
authors: Elizabeth
authors: E
authors: Selvin
authors: William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts;
authors: Lesley A
authors: LA
authors: Inker
authors: William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts;
authors: Andrew S
authors: AS
authors: Levey
authors: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland;
authors: Paul L
authors: PL
authors: Kimmel
authors: Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts;
authors: Ramachandran S
authors: RS
authors: Vasan
authors: Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, Minnesota;
authors: John H
authors: JH
authors: Eckfeldt
authors: Departments of Biostatistics and Epidemiology, and Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;
authors: Harold I
authors: HI
authors: Feldman
authors: Division of Nephrology, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California; and.
authors: Chi-Yuan
authors: CY
authors: Hsu
authors: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
authors: Pamela L
authors: PL
authors: Lutsey
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D050197:Atherosclerosis / Q000097:blood; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005786:Gene Expression Regulation; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; C104450:25-hydroxyvitamin D
keywords: ESRD; mineral metabolism; risk factors