title: Plasma levels of fibroblast growth factor-23 are associated with muscle mass in haemodialysis patients.
abstract: OBJECTIVE
  Malnutrition is highly prevalent in haemodialysis (HD) patients, and it contributes to morbidity and mortality. Fibroblast growth factor-23 (FGF-23) and Klotho contribute to chronic kidney disease-mineral and bone disorder (CKD-MBD) in HD patients, but the role that these molecules play in determining nutritional status is currently unknown.
  
  
  METHODS
  A cross-sectional study examining 77 HD patients was performed. The plasma concentrations of FGF-23 and soluble Klotho (s-Klotho) were studied to evaluate their association with muscle mass, which was investigated by abdominal muscle areas measured using computed tomography and by creatinine (Cr) production estimated using the Cr kinetic model.
  
  
  RESULTS
  Plasma FGF-23 concentrations were significantly and positively correlated with abdominal muscle areas and Cr production (rho = 0.301, P < 0.01 and rho = 0.345, P < 0.01, respectively). In contrast, s-Klotho was not significantly correlated with these muscle mass indices and plasma FGF-23 concentrations. Multiple regression analyses showed that FGF-23 was a significant independent predictor of both muscle mass indices (P < 0.01 and P < 0.05, respectively).
  
  
  CONCLUSIONS
  Plasma FGF-23 concentrations were associated with muscle mass indices in HD patients. Our findings suggest that FGF-23 and nutritional status are linked and this link is most likely independent of s-Klotho.
authors.affiliation: Renal Division, Department of Internal Medicine, Iwata City Hospital, Iwata, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Fukasawa
authors.forename: Sayaka
authors.initials: S
authors.lastname: Ishigaki
authors.forename: Naoko
authors.initials: N
authors.lastname: Kinoshita-Katahashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Niwa
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasuda
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Kumagai
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Furuya
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005966:Glucuronidase / Q000097:blood; D006801:Humans; D000090265:Klotho Proteins; D008297:Male; D044342:Malnutrition / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D003404:Creatinine; D005966:Glucuronidase; D000090265:Klotho Proteins
keywords: fibroblast growth factor-23; haemodialysis; malnutrition; protein-energy wasting; soluble Klotho (s-Klotho)