Relationship between GFR, intact PTH, oxidized PTH, non‐oxidized PTH as well as FGF23 in patients with CKD

Zeng, Shufei; Querfeld, Uwe; Feger, Martina; Haffner, Dieter; Hasan, Ahmed A.; Chu, Chang; Slowinski, Torsten; Dschietzig, Thomas; Schäfer, Franz; Xiong, Yingquan; Zhang, Bingbing; Rausch, Steffen; Horvathova, Katarina; Läng, Florian; Krämer, Bernhard K.; Föller, Michael; Hocher, Berthold

doi:10.1096/fj.202000596r

Cited by 14 publications

(16 citation statements)

References 48 publications

(112 reference statements)

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“…5,22 This was also recently corroborated by a study assessing the FGF23 stimulating effects of several oxPTH forms. 23 As we do not know the amount of ox(Met18)PTH, compared to ox(Met8)PTH or ox(Met8,18)PTH, it could be that the quantification of biologically active PTH by the methods used in the current study, is an underestimation. One could speculate that separation of the fragments may result in more optimal interpretation of PTH results.…”

Section: Discussionmentioning

confidence: 82%

Non-oxidized parathyroid hormone (PTH) measured by current method is not superior to total PTH in assessing bone turnover in chronic kidney disease

Ursem

Heijboer

D’Haese

et al. 2021

Kidney International

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Section: Discussionmentioning

confidence: 82%

Non-oxidized parathyroid hormone (PTH) measured by current method is not superior to total PTH in assessing bone turnover in chronic kidney disease

Ursem

Heijboer

D’Haese

et al. 2021

Kidney International

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“…Although most of the participants with CKD in this study were in stage 1 and stage 2, we also used this HP definition in patients with CKD stages 3-5; thus, it may affect the accuracy. In addition, some potential confounders, such as the hemodialysis condition (the patients with nondialysis dependent or hemodialysis CKD, a hemodialysis type, etc.,), drugs use, and fibroblast growth factor 23 (FGF23), may influence this association, but these confounders were not available in NHANES data (56,(66)(67)(68). Another limitation was that PTH was only assayed at a single time point; thus, no repeat measurements of PTH were conducted.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Dietary Inflammatory Index and Parathyroid Hormone in Adults With/Without Chronic Kidney Disease

et al. 2021

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Aims: We aimed to assess the association between dietary inflammation index (DII) with parathyroid hormone (PTH) and hyperparathyroidism (HP) in adults with/without chronic kidney disease (CKD).Methods: Data were obtained from the 2003–2006 National Health and Nutrition Examination Survey (NHANES). The participants who were <18 years old, pregnant, or missing the data of DII, PTH, and CKD were excluded. DII was calculated based on a 24-h dietary recall interview for each participant. Weighted multivariable regression analysis and subgroup analysis were conducted to estimate the independent relationship between DII with PTH and the HP in the population with CKD/non-CKD.Results: A total of 7,679 participants were included with the median DII of −0.24 (−2.20 to 1.80) and a mean PTH level of 43.42 ± 23.21 pg/ml. The average PTH was 45.53 ± 26.63 pg/ml for the participants in the highest tertile group compared with 41.42 ± 19.74 pg/ml in the lowest tertile group (P < 0.0001). The rate of HP was 11.15% overall, while the rate in the highest DII tertile was 13.28 and 8.60% in the lowest DII tertile (P < 0.0001). The participants with CKD tended to have higher PTH levels compared with their counterparts (61.23 ± 45.62 vs. 41.80 ± 19.16 pg/ml, P < 0.0001). A positive association between DII scores and PTH was observed (β = 0.46, 95% CI: 0.25, 0.66, P ≤ 0.0001), and higher DII was associated with an increased risk of HP (OR = 1.05, 95% CI: 1.02, 1.08, P = 0.0023). The results from subgroup analysis indicated that this association was similar in the participants with different renal function, gender, age, BMI, hypertension, and diabetes statuses and could also be appropriate for the population with CKD.Conclusions: Higher consumption of a pro-inflammatory diet appeared to cause a higher PTH level and an increased risk of HP. Anti-inflammatory dietary management may be beneficial to reduce the risk of HP both in the population with and without CKD.

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“…Moreover, metformin-induced lactic acidosis typically affects patients with severe CKD [ 78 ]. Since FGF23 plasma levels go up early in CKD and predict prognosis [ 26 , 79 ], lactic acid-induced FGF23 production may also be a mechanism relevant in CKD.…”

Section: Discussionmentioning

confidence: 99%

Lactic acid induces fibroblast growth factor 23 (FGF23) production in UMR106 osteoblast-like cells

Alber

Föller

2021

Mol Cell Biochem

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Endocrine and paracrine fibroblast growth factor 23 (FGF23) is a protein predominantly produced by bone cells with strong impact on phosphate and vitamin D metabolism by targeting the kidney. Plasma FGF23 concentration early rises in kidney and cardiovascular diseases correlating with progression and outcome. Lactic acid is generated in anaerobic glycolysis. Lactic acidosis is the consequence of various physiological and pathological conditions and may be fatal. Since FGF23 production is stimulated by inflammation and lactic acid induces pro-inflammatory signaling, we investigated whether and how lactic acid influences FGF23. Experiments were performed in UMR106 osteoblast-like cells, Fgf23 mRNA levels estimated from quantitative real-time polymerase chain reaction, and FGF23 protein determined by enzyme-linked immunosorbent assay. Lactic acid dose-dependently induced Fgf23 gene expression and up-regulated FGF23 synthesis. Also, Na+-lactate as well as formic acid and acetic acid up-regulated Fgf23. The lactic acid effect was significantly attenuated by nuclear factor kappa-light-chain enhancer of activated B-cells (NFκB) inhibitors wogonin and withaferin A. Lactic acid induces FGF23 production, an effect at least in part mediated by NFκB. Lactic acidosis may, therefore, be paralleled by a surge in plasma FGF23.

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Relationship between GFR, intact PTH, oxidized PTH, non‐oxidized PTH as well as FGF23 in patients with CKD

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 14 publications

References 48 publications

Non-oxidized parathyroid hormone (PTH) measured by current method is not superior to total PTH in assessing bone turnover in chronic kidney disease

Non-oxidized parathyroid hormone (PTH) measured by current method is not superior to total PTH in assessing bone turnover in chronic kidney disease

The Association Between Dietary Inflammatory Index and Parathyroid Hormone in Adults With/Without Chronic Kidney Disease

Lactic acid induces fibroblast growth factor 23 (FGF23) production in UMR106 osteoblast-like cells

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