Fibroblast Growth Factor 23 Trajectories in Chronic Hemodialysis Patients: Lessons from the HEMO Study

American Journal of Nephrology
Anna JovanovichJessica Kendrick

Abstract

Long-term patterns of fibroblast growth factor 23 (FGF23) are poorly characterized among dialysis patients. To identify different FGF23 trajectories and determine clinical factors that predict distinct FGF23 trajectories and whether FGF23 trajectories differ in regard to their associations with all-cause mortality among prevalent hemodialysis patients. The HEMO study was a randomized multicenter study evaluating the effects of high-dose vs. standard-dose and high-flux vs. low-flux hemodialysis on mortality. We measured intact FGF23 levels in stored serum samples at baseline and annually among 919 HEMO participants and identified FGF23 trajectories using group-based modeling. Logistic regression determined predictors of trajectories. Cox regression models evaluated the association between trajectory and all-cause mortality. We identified 5 distinct FGF23 trajectory groups during the initial 24 months: low stable, low increasing, elevated increasing, elevated decreasing, and elevated stable. In multivariable models, diabetes, high dose dialysis, no venous catheter, low serum calcium, phosphorus, and interleukin-6, no vitamin D analog use, and greater residual kidney function were associated with the low stable trajectory group co...Continue Reading

Citations

Mar 5, 2020·Journal of Nephrology·Annet Bouma-de Krijger, Marc G Vervloet
Mar 12, 2020·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Martina FegerMichael Föller
Jun 10, 2020·Expert Review of Molecular Diagnostics·Yuichiro KondoMasafumi Fukagawa

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