The prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysis
Fibroblast growth factor 23 (FGF23) is a phosphotropic hormone secreted by osteoblasts and osteocytes into the systemic circulation. It exerts its effects on the kidneys, parathyroid glands, heart, and bones. FGF23 is a critical phosphaturic hormone that, alongside parathyroid hormone (PTH), regula...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
National Kidney Foundation of Ukraine
2025-06-01
|
| Series: | Український Журнал Нефрології та Діалізу |
| Subjects: | |
| Online Access: | https://ukrjnd.com.ua/index.php/journal/article/view/941 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849692324222730240 |
|---|---|
| author | Vladyslav Bardash Tetiana Maksymets Eugen Sklyarov |
| author_facet | Vladyslav Bardash Tetiana Maksymets Eugen Sklyarov |
| author_sort | Vladyslav Bardash |
| collection | DOAJ |
| description |
Fibroblast growth factor 23 (FGF23) is a phosphotropic hormone secreted by osteoblasts and osteocytes into the systemic circulation. It exerts its effects on the kidneys, parathyroid glands, heart, and bones. FGF23 is a critical phosphaturic hormone that, alongside parathyroid hormone (PTH), regulates phosphate reabsorption and calcitriol (1,25(OH)₂D) synthesis in the kidneys. The present study aimed to evaluate the diagnostic and prognostic significance of fibroblast growth factor 23 in patients undergoing hemodialysis.
Methods. A total of 88 patients were examined in this cross-sectional study. The cohort comprised 36 women (40.9%; 95% CI 30.64–51.18) and 52 men (59.1%; 95% CI 48.82–69.36), with a mean age of 55.81 ± 13.14 years. Group 1 consisted of 69 patients with stage 5 chronic kidney disease (CKD) receiving renal replacement therapy via hemodialysis, while Group 2 included 19 patients with stage 3 CKD.
Results. FGF23 levels were elevated in 67 patients (97.1%; 95% CI 91.87–99.72) in Group 1, with a median (Me) of 1258.32 pg/mL (interquartile range [IQR] 169.46–1338.46). In Group 2, FGF23 levels were elevated in 18 patients (94.7%; 95% CI 80.58–100), with a median of 150.5 pg/mL (IQR 74.22–929.12). A significant difference was observed between the groups (p < 0.05). The median duration of hemodialysis in Group 1 was 15 months (IQR 8–36). In Group 1, correlation analysis revealed weak associations between FGF23 and phosphorus (r = 0.13; p > 0.05), total calcium (r = 0.04; p < 0.05), ionized calcium (r = 0.02; p < 0.05), and parathyroid hormone (r = 0.08; p > 0.05). Significant correlations were found between FGF23 and creatinine (r = 0.41; p < 0.005), urea (r = 0.33; p < 0.005), urine volume (r = -0.75; p < 0.005), and hemodialysis duration (r = 0.57; p < 0.005). Regression analysis for predicting residual urine volume based on FGF23, creatinine, urea, and hemodialysis duration yielded an R² of 0.7369, F-statistic of 92.45 (p < 0.0001), standard error of residuals of 5.843, and residual degrees of freedom of 66.
Conclusions. The weak correlations between FGF23 and calcium-phosphorus metabolism indicate that FGF23 is not a suitable diagnostic marker for mineral and bone disorders (CKD-MBD) in patients undergoing hemodialysis. However, FGF23 is a significant predictor of residual urine volume in hemodialysis patients, as demonstrated by the regression analysis. The model, incorporating FGF23 and hemodialysis duration, explains 73.7% of the variation in urine volume, highlighting its strong prognostic capability. These findings underscore the clinical significance of FGF23 as a biomarker for assessing residual renal function in dialysis patients.
|
| format | Article |
| id | doaj-art-582c0def97e64c6dadc91eaba97baea5 |
| institution | DOAJ |
| issn | 2304-0238 2616-7352 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | National Kidney Foundation of Ukraine |
| record_format | Article |
| series | Український Журнал Нефрології та Діалізу |
| spelling | doaj-art-582c0def97e64c6dadc91eaba97baea52025-08-20T03:20:44ZengNational Kidney Foundation of UkraineУкраїнський Журнал Нефрології та Діалізу2304-02382616-73522025-06-012(86)10.31450/ukrjnd.2(86).2025.05The prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysisVladyslav Bardash0Tetiana Maksymets1Eugen Sklyarov2Danylo Halytsky Lviv National Medical University, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, Ukraine Fibroblast growth factor 23 (FGF23) is a phosphotropic hormone secreted by osteoblasts and osteocytes into the systemic circulation. It exerts its effects on the kidneys, parathyroid glands, heart, and bones. FGF23 is a critical phosphaturic hormone that, alongside parathyroid hormone (PTH), regulates phosphate reabsorption and calcitriol (1,25(OH)₂D) synthesis in the kidneys. The present study aimed to evaluate the diagnostic and prognostic significance of fibroblast growth factor 23 in patients undergoing hemodialysis. Methods. A total of 88 patients were examined in this cross-sectional study. The cohort comprised 36 women (40.9%; 95% CI 30.64–51.18) and 52 men (59.1%; 95% CI 48.82–69.36), with a mean age of 55.81 ± 13.14 years. Group 1 consisted of 69 patients with stage 5 chronic kidney disease (CKD) receiving renal replacement therapy via hemodialysis, while Group 2 included 19 patients with stage 3 CKD. Results. FGF23 levels were elevated in 67 patients (97.1%; 95% CI 91.87–99.72) in Group 1, with a median (Me) of 1258.32 pg/mL (interquartile range [IQR] 169.46–1338.46). In Group 2, FGF23 levels were elevated in 18 patients (94.7%; 95% CI 80.58–100), with a median of 150.5 pg/mL (IQR 74.22–929.12). A significant difference was observed between the groups (p < 0.05). The median duration of hemodialysis in Group 1 was 15 months (IQR 8–36). In Group 1, correlation analysis revealed weak associations between FGF23 and phosphorus (r = 0.13; p > 0.05), total calcium (r = 0.04; p < 0.05), ionized calcium (r = 0.02; p < 0.05), and parathyroid hormone (r = 0.08; p > 0.05). Significant correlations were found between FGF23 and creatinine (r = 0.41; p < 0.005), urea (r = 0.33; p < 0.005), urine volume (r = -0.75; p < 0.005), and hemodialysis duration (r = 0.57; p < 0.005). Regression analysis for predicting residual urine volume based on FGF23, creatinine, urea, and hemodialysis duration yielded an R² of 0.7369, F-statistic of 92.45 (p < 0.0001), standard error of residuals of 5.843, and residual degrees of freedom of 66. Conclusions. The weak correlations between FGF23 and calcium-phosphorus metabolism indicate that FGF23 is not a suitable diagnostic marker for mineral and bone disorders (CKD-MBD) in patients undergoing hemodialysis. However, FGF23 is a significant predictor of residual urine volume in hemodialysis patients, as demonstrated by the regression analysis. The model, incorporating FGF23 and hemodialysis duration, explains 73.7% of the variation in urine volume, highlighting its strong prognostic capability. These findings underscore the clinical significance of FGF23 as a biomarker for assessing residual renal function in dialysis patients. https://ukrjnd.com.ua/index.php/journal/article/view/941fibroblast growth factor 23, chronic kidney disease, hemodialysis, calcium-phosphate metabolism, diuresis. |
| spellingShingle | Vladyslav Bardash Tetiana Maksymets Eugen Sklyarov The prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysis Український Журнал Нефрології та Діалізу fibroblast growth factor 23, chronic kidney disease, hemodialysis, calcium-phosphate metabolism, diuresis. |
| title | The prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysis |
| title_full | The prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysis |
| title_fullStr | The prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysis |
| title_full_unstemmed | The prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysis |
| title_short | The prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysis |
| title_sort | prognostic and diagnostic value of fibroblast growth factor 23 in patients undergoing hemodialysis |
| topic | fibroblast growth factor 23, chronic kidney disease, hemodialysis, calcium-phosphate metabolism, diuresis. |
| url | https://ukrjnd.com.ua/index.php/journal/article/view/941 |
| work_keys_str_mv | AT vladyslavbardash theprognosticanddiagnosticvalueoffibroblastgrowthfactor23inpatientsundergoinghemodialysis AT tetianamaksymets theprognosticanddiagnosticvalueoffibroblastgrowthfactor23inpatientsundergoinghemodialysis AT eugensklyarov theprognosticanddiagnosticvalueoffibroblastgrowthfactor23inpatientsundergoinghemodialysis AT vladyslavbardash prognosticanddiagnosticvalueoffibroblastgrowthfactor23inpatientsundergoinghemodialysis AT tetianamaksymets prognosticanddiagnosticvalueoffibroblastgrowthfactor23inpatientsundergoinghemodialysis AT eugensklyarov prognosticanddiagnosticvalueoffibroblastgrowthfactor23inpatientsundergoinghemodialysis |