Correlations and time course of FGF23 and markers of bone metabolism in maintenance hemodialysis patients

Bielesz, Bernhard; Hecking, Manfred; Plischke, Max; Cejka, Daniel; Kieweg, Heidi; Haas, Martin; Marculescu, Rodrig; Hörl, Walter H.; Bieglmayer, Christian; Sunder‐Plassmann, Gere

doi:10.1016/j.clinbiochem.2014.06.009

Cited by 7 publications

(7 citation statements)

References 16 publications

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“…Based on the fact that HD helps to remove the extracorporeal waste products such as toxins and free water in order to correct the electrolyte and acid‐base imbalances, researchers are exploring valuable molecular targets to improve HD efficacy. Although previous studies have demonstrated that cardiac troponin T, Brain natriuretic peptide (BNP), N‐terminal‐proBNP, and ferritin are all predictors of HD efficacy, their sensitivity and specificity were not documented . More molecular markers for HD efficacy evaluation with high sensitivity and specificity might be of help for ESRD treatment.…”

Section: Introductionmentioning

confidence: 99%

CD62P and P10 as predictive markers for assessing the efficacy of hemodialysis in treating end‐stage renal disease

Wang

et al. 2018

Clinical Laboratory Analysis

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Background CD62P is a platelet α‐granule membrane protein, and P10 is a platelet membrane glycoprotein thrombospondin. To better understand the effects of hemodialysis (HD), we have conducted this study to investigate CD62P and P10 in assessing the efficacy of HD in treating patients with end‐stage renal disease (ESRD). Methods The case group consisted of 111 patients suffering ESRD treated with regular HD and the control group enrolled 117 healthy subjects. Before and after HD treatment, a series of parameters were observed, based on which, CD62P and P10 levels were detected in the patients in two groups before and after HD therapy. The correlation analysis analyzed the correlations of CD62P and P10 markers with serum creatinine (Scr), blood urea nitrogen (BUN), and subjective score; and logistic regression analysis was performed to reveal factors affecting the efficacy of HD. Results BUN, Scr, serum phosphorus, intact parathyroid hormone (iPTH), fibrinogen, and β2‐microglobulin (β2‐MG) decreased while hemoglobin, albumin, and activated partial thromboplastin time increased in the patients suffering ESRD; patients presented with improvements in subjective symptoms and an increase in dry weight. CD62P and P10 levels were lower in post‐treatment patients. CD62P and P10 positively correlated with Scr, BUN and subjective score; post‐treatment CD62P and P10 levels, BUN, hemoglobin, albumin, triglyceride, iPTH, β2‐MG, and fibrinogen were correlated with the efficacy of HD. Conclusion CD62P and P10 might be correlated to the efficacy of HD in treating ESRD, in turn providing predictive markers for assessing the ability of HD in treating ESRD.

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Section: Introductionmentioning

confidence: 99%

CD62P and P10 as predictive markers for assessing the efficacy of hemodialysis in treating end‐stage renal disease

Wang

et al. 2018

Clinical Laboratory Analysis

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“…However, cell-sensing mechanisms triggering FGF23 production and secretion have not been fully characterized. Some studies have failed to demonstrate significant changes in serum FGF23 levels following short-term control of serum phosphate, calcium or PTH [ 13 , 14 ]. Furthermore, the level of complexity of FGF23 regulation has further increased because of recent evidence that both inflammation and iron status also influence the production of FGF23 [ 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Phosphate control in reducing FGF23 levels in hemodialysis patients

et al. 2018

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BackgroundIn hemodialysis patients, high levels of Fibroblast Growth Factor 23 (FGF23) predict mortality. Our study was designed to test whether the control of serum phosphate is associated with a reduction in serum FGF23 levels. Additionally other variables with a potential effect on FGF23 levels were evaluated.Material and methodsThe effect of sustained (40-weeks) control of serum phosphate on FGF23 levels (intact and c-terminal) was evaluated in 21 stable hemodialysis patients that were not receiving calcimimetics or active vitamin D. Patients received non-calcium phosphate binders to maintain serum phosphate below 4.5 mg/dl. In an additional analysis, values of intact-FGF23 (iFGF23) and c-terminal FGF23 (cFGF23) from 150 hemodialysis patients were correlated with parameters of mineral metabolism and inflammation. Linear mixed models and linear regression were performed to evaluate longitudinal trajectories of variables and the association between FGF23 and the other variables examined.ResultsDuring the 40-week treatment, 12 of 21 patients achieved the target of serum phosphate <4.5 mg/dl. In these 12 patients, iFGF23 decreased to less than half whereas cFGF23 did not reduce significantly. In patients with serum phosphate >4.5 mg, iFGF23 and cFGF23 increased two and four-fold respectively as compared with baseline. Furthermore, changes in serum phosphate correlated with changes in C-reactive protein (hs-CRP). In our 150 hemodialysis patients, those in the higher tertile of serum phosphate also showed increased hs-CRP, iPTH, iFGF23 and cFGF23. Multiple regression analysis revealed that iFGF23 levels directly correlated with both serum phosphate and calcium, whereas cFGF23 correlated with serum phosphate and hs-CRP but not with calcium.ConclusionsThe control of serum phosphate reduced iFGF23. This reduction was also associated with a decreased in inflammatory parameters. Considering the entire cohort of hemodialysis patients, iFGF23 levels correlated directly with serum phosphate levels and also correlated inversely with serum calcium concentration. The levels of cFGF23 were closely related to serum phosphate and parameters of inflammation.

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“…Bone biopsy information is also needed but rarely collected in many parts of the world. In particular, some new parameters such as β-crosslaps 14 and fibroblast growth factor-23 15 were not included in this study, but represent future directions of research related to hemodialysis-associated secondary hyperparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the parathyroid function in maintenance hemodialysis patients from Changchun, China

Du¹,

Wang²,

Yu³

et al. 2017

Chronic Diseases and Translational Medicine

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ObjectiveTo evaluate the parathyroid function in maintenance hemodialysis patients from 4 hemodialysis centers and to analyze the cause of the dysfunction.MethodsThis cross-sectional study included patients with chronic renal disease undergoing maintenance hemodialysis treatment at 4 hemodialysis centers in Changchun, China, between March 2014 and August 2015. A total of 337 patients were asked to complete a questionnaire including their name, gender, age, hemodialysis duration, the use of calcium carbonate and vitamin D3 supplements, health education status, hemofiltration frequency, appetite, and education level. Serum intact parathyroid hormone (iPTH), phosphorus, total calcium, blood urea nitrogen (BUN), and creatinine (Cre) levels were obtained from clinical information. Patients with iPTH data were divided into 2 groups: Normal group: the patients with an iPTH level < 100 pg/ml (28 subjects); Abnormal group: the patients with an iPTH level > 100 pg/ml (136 subjects). Intergroup differences were analyzed using the t-test. The enumeration data were analyzed by the χ2 test.ResultsThe iPTH levels were not monitored for 173 maintenance hemodialysis patients (51.3%) but for 164 patients (48.7%). Of the 164 patients, 28 (17.1%) had a normal serum iPTH level, while the other 136 (82.9%) had an abnormal iPTH level. The maintenance hemodialysis duration and phosphorus levels in the Abnormal group were higher than those in the Normal group (P < 0.05). The appetites of patients in the Abnormal group were better than those of patients in the Normal group (P < 0.05).ConclusionsA lower proportion of patients on hemodialysis had a normal iPTH level. The phosphorus levels of patients on hemodialysis should be controlled via dietary interventions.

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Correlations and time course of FGF23 and markers of bone metabolism in maintenance hemodialysis patients

Cited by 7 publications

References 16 publications

CD62P and P10 as predictive markers for assessing the efficacy of hemodialysis in treating end‐stage renal disease

CD62P and P10 as predictive markers for assessing the efficacy of hemodialysis in treating end‐stage renal disease

Phosphate control in reducing FGF23 levels in hemodialysis patients

Analysis of the parathyroid function in maintenance hemodialysis patients from Changchun, China

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