Association between fibroblast growth factor 23 and functional capacity among independent elderly individuals

Araújo, Lara Miguel Quirino; Moreira, Patrícia Ferreira do Prado; Filho, Clineu de Mello Almada; Araújo, Luciano Vieira de; Costa, Aline G.; Sesso, Ricardo; Bilezikian, John P.; Lazaretti-Castro, Marise; Cendoroglo, Maysa Seabra

doi:10.31744/einstein_journal/2021ao5925

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…Furthermore, a cross-sectional study with 263 prevalent patients with HD showed high FGF23 that may have contributed to cognitive impairment ( 31 ). However, elderly patients with CKD not on dialysis showed no relationship between high FGF23 and cognitive functional capacity ( 32 ), and an animal study showed that FGF23 deficiency impairs hippocampal-dependent cognitive function ( 33 ). Persistent FGF 23 is one cause of secondary hyperparathyroidism in CKD as a long-term inducer of parathyroid cell proliferation and PTH secretion ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Glymphatic Dysfunction in Patients With End-Stage Renal Disease

et al. 2022

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BackgroundWe aimed to compare glymphatic dysfunction between patients with end-stage renal disease (ESRD) and healthy controls and analyze the correlation between the glymphatic function and clinical characteristics using the diffusion tensor image analysis along with the perivascular space (DTI-ALPS) index.MethodsWe prospectively enrolled neurologically asymptomatic 49 patients with ESRD undergoing dialysis and 38 healthy controls. Diffusion tensor image was conducted using the same 3T scanner, and the DTI-ALPS index was calculated. We compared the DTI-ALPS index between the patients with ESRD and healthy controls. In addition, we conducted a correlation analysis between the clinical characteristics and DTI-ALPS index in patients with ESRD.ResultsThere were significant differences in the DTI-ALPS index between patients with ESRD and healthy controls. The DTI-ALPS index in patients with ESRD was lower than that in healthy controls (1.460 vs. 1.632, p = 0.003). In addition, there was a significant positive correlation between the DTI-ALPS index and serum parathyroid hormone levels (r = 0.357, p = 0.011).ConclusionWe demonstrated glymphatic dysfunction in patients with ESRD, as revealed by the DTI-ALPS index. This study also reveals the feasibility of the DTI-ALPS method to determine glymphatic function in patients with ESRD, which could be used in future research studies.

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Section: Discussionmentioning

confidence: 99%

Glymphatic Dysfunction in Patients With End-Stage Renal Disease

et al. 2022

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Intact FGF23 predicts serum phosphate improvement after combined nicotinamide and phosphate binder treatment in hemodialysis patients

Egli-Spichtig

Hamid

Arroyo

et al. 2023

Clinical Kidney Journal

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Background Hyperphosphatemia is associated with increased mortality and cardiovascular morbidity of end-stage kidney failure (ESKF) patients. Managing serum phosphate in ESKF patients is challenging and mostly based on limiting intestinal phosphate absorption with low phosphate diets and phosphate binders (PB). In a multi-centric, double-blinded, placebo-controlled study cohort of maintenance hemodialysis patients with hyperphosphatemia, we demonstrated the efficacy of nicotinamide modified release (NAMR) formulation treatment in addition to standard PB therapy in decreasing serum phosphate. Here we aimed to assess the relationship between phosphate, FGF23, inflammation and iron metabolism in this cohort. Methods We measured the plasma concentrations of intact fibroblast growth factor 23 (iFGF23) and selected proinflammatory cytokines at baseline and week 12 after initiating treatment. Results We observed a strong correlation between iFGF23 and cFGF23 (C-terminal fragment plus iFGF23). We identified iFGF23 as a better predictor of changes in serum phosphate induced by NAMR and PB treatment compared to cFGF23. Recursive partitioning revealed at baseline and week 12, that iFGF23 and cFGF23 together with T50 propensity were the most important predictors of serum phosphate, whereas parathyroid hormone (iPTH) played a minor role in this model. Furthermore, we found serum phosphate and iPTH as the best predictors of iFGF23 and cFGF23. Sex, age, BMI and markers of inflammation and iron metabolism had only a minor impact in predicting FGF23. Conclusion Lowering serum phosphate in ESKF patients may depend highly on iFGF23 which is correlated to cFGF23 levels. Serum phosphate was the most important predictor of plasma FGF23 in this ESKF cohort.

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Association between fibroblast growth factor 23 and functional capacity among independent elderly individuals

Cited by 2 publications

References 26 publications

Glymphatic Dysfunction in Patients With End-Stage Renal Disease

Glymphatic Dysfunction in Patients With End-Stage Renal Disease

Intact FGF23 predicts serum phosphate improvement after combined nicotinamide and phosphate binder treatment in hemodialysis patients

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