Association Between Fibroblast Growth Factor 23 and Left Ventricular Hypertrophy in Maintenance Hemodialysis Patients - Comparison With B-Type Natriuretic Peptide and Cardiac Troponin T -

Negishi, Kazuaki; Kobayashi, Masaru; Ochiai, Izuru; Yamazaki, Y.; Higuchi, Hisashi; Yamashita, Takefumi; Shimizu, Tomohiro; Kasama, Shu; Kurabayashi, Masahiko

doi:10.1253/circj.cj-10-0355

Cited by 51 publications

(43 citation statements)

References 31 publications

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“…Likewise, in patients undergoing coronary angiography, again with minimal renal dysfunction (19% eGFR,60 ml/min per 1.73 m 2 ), FGF23 has primarily been associated with left ventricular dysfunction (61). Moreover, although higher FGF23 concentrations have been associated with numerous intermediate markers of vascular disease in both adult and pediatric CKD cohorts, the most consistent associations by far are with left ventricular mass index (LVMI) and left ventricular hypertrophy (LVH) (7,(61)(62)(63)(64)(65). Analysis of CRIC shows not only a strong independent association between FGF23 and LVMI and the prevalence of LVH but also, the ability of FGF23 levels to predict incident LVH as well (7).…”

Section: Fgf23-direct Link To Pathology?mentioning

confidence: 99%

The Use of Fibroblast Growth Factor 23 Testing in Patients with Kidney Disease

Smith

2014

Clinical Journal of the American Society of Nephrology

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The emergence of fibroblast growth factor 23 as a potentially modifiable risk factor in CKD has led to growing interest in its measurement as a tool to assess patient risk and target therapy. This review discusses the analytical and clinical challenges faced in translating fibroblast growth factor 23 testing into routine practice. As for other bone mineral markers, agreement between commercial fibroblast growth factor 23 assays is poor, mainly because of differences in calibration, but also, these differences reflect the variable detection of hormone fragments. Direct comparison of readout from different assays is consequently limited and likely hampers setting uniform fibroblast growth factor 23-directed targets. Efforts are needed to standardize assay output to enhance clinical use. Fibroblast growth factor 23 is robustly associated with cardiovascular and renal outcomes in patients with CKD and adds value to risk assessments based on conventional risk factors. Compared with most other mineral markers, fibroblast growth factor 23 shows better intraindividual temporal stability, with minimal diurnal and week-to-week variability, but substantial interindividual variation, maximizing discriminative power for risk stratification. Conventional therapeutic interventions for the CKD-mineral bone disorder, such as dietary phosphate restriction and use of oral phosphate binders or calcimimetics, are associated with variable efficacy at modulating circulating fibroblast growth factor 23 concentrations, like they are for other mineral metabolites. Dual therapy with dietary phosphate restriction and noncalcium-based binder use achieves the most consistent fibroblast growth factor 23-lowering effect and seems best monitored using an intact assay. Additional studies are needed to evaluate whether strategies aimed at reducing levels or antagonizing its action have beneficial effects on clinical outcomes in CKD patients. Moreover, a better understanding of the mechanisms driving fibroblast growth factor 23 elevations in CKD is needed to inform the use of therapeutic interventions targeting fibroblast growth factor 23 excess. This evidence must be forthcoming to support the use of fibroblast growth factor 23 measurement and fibroblast growth factor 23-directed therapy in the clinic.

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Section: Fgf23-direct Link To Pathology?mentioning

confidence: 99%

The Use of Fibroblast Growth Factor 23 Testing in Patients with Kidney Disease

Smith

2014

Clinical Journal of the American Society of Nephrology

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“…FGF-23 levels are extremely high in hemodialysis patients and are independently associated with increased mortality in these population. 24,25 In most hemodialyzed patients, serum FGF-23 concentration is more than 100-fold higher than in controls. 25 osteopontin, and osteoprotegerin.…”

mentioning

confidence: 99%

“…FGF-23 levels in our study were higher than those reported in the literature (TAbLE 1). 13,24,25 The relationships between the CCA-IMT and selected bone metabolism markers as well as cardiovascular risk factors were studied using simple correlations as well as a multiple regression. Osteoprotegerin was the only bone marker that significantly correlated with CCA-IMT in a simple analysis (r = 0.38, P = 0.004) (FIGuRE).…”

mentioning

confidence: 99%

Osteoprotegerin as a marker of cardiovascular risk in patients on peritoneal dialysis

Janda¹,

Krzanowski²,

Chowaniec³

et al. 2013

Polish Archives of Internal Medicine

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“…Although left ventricular hypertrophy is reported to be associated with AF, 33 it may not explain the U-shaped association, because serum FGF23 had a linear relationship with left ventricular hypertrophy in the current study, which in agreement with the previous studies. 15,25, 34 It was shown that higher PTH was associated with AF. 35 Both PTH and FGF23 have been shown to be associated with endothelial dysfunction, 36-38 and they may also be associated with myocardial fibrosis, 39,40 conditions that may also be related to AF.…”

Section: Discussionmentioning

confidence: 99%