Strength of Fibroblast Growth Factor 23 as a Cardiovascular Risk Predictor in Chronic Kidney Disease Weaken by ProBNP Adjustment

American Journal of Nephrology
Insa E EmrichGunnar H Heine

Abstract

Various epidemiological studies linked high fibroblast growth factor 23 (FGF23) levels with cardiovascular events in chronic kidney disease (CKD). It remains enigmatic whether high FGF23 exerts adverse cardiovascular effects, or whether it reflects detrimental effects of residual confounders. Earlier studies adjusted for CKD-mineral bone disease (CKD-MBD) regulators of FGF23 rather than for recently discovered non-CKD-MBD regulators, among which iron deficiency and heart failure are of particular importance. Moreover, they used c-terminal FGF23 (cFGF23) assays rather than more specific intact FGF23 (iFGF23) assays. The CARE FOR HOMe study analyzed plasma ferritin, iFGF23, cFGF23 and N-terminal proBNP (NT-proBNP) along with conventional risk factors, among 575 CKD G2-G4 patients to determine the interaction between FGF23, its non-CKD-MBD regulators, and incident cardiovascular events in CKD patients. The participants were followed up for 5.1 ± 2.1 years for the occurrence of atherosclerotic events and hospitalization for acute decompensated heart failure. cFGF23 correlated strongly with high iFGF23 (r = 0.607), fairly with high NT-proBNP (r = 0.453) and weakly with low ferritin (r = -0.207); correlation coefficients of iFGF23 wi...Continue Reading

Citations

Feb 6, 2020·European Journal of Heart Failure·Robert StöhrHans-Peter Brunner-la Rocca
Mar 5, 2020·Journal of Nephrology·Annet Bouma-de Krijger, Marc G Vervloet
Sep 21, 2020·The Journal of Clinical Endocrinology and Metabolism·Shilpa SharmaJoachim H Ix
Jun 1, 2021·Disease Markers·Anna KurpasMarzenna Zielińska
Jun 8, 2021·Frontiers in Cell and Developmental Biology·Farhad KhosraviHeinrich Sauer

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