Prognostic Value of Fibroblast Growth Factor 23 in Autosomal Dominant Polycystic Kidney Disease.

Abstract

INTRODUCTION:

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by progressive cyst growth and a loss of functioning renal mass, but a decline in glomerular filtration rate (GFR) and onset of end-stage renal disease (ESRD) occur late in the disease course. There is therefore a great need for early prognostic biomarkers in this disorder.

METHODS:

We measured baseline serum fibroblast growth factor 23 (FGF23) levels in 192 patients with ADPKD from the Consortium for Radiologic Imaging Studies of PKD (CRISP) cohort that were followed for a median of 13 years and tested the association between FGF23 levels and change over time in height-adjusted total kidney volume (htTKV), GFR, and time to the composite endpoints of ESRD, death, and doubling of serum creatinine.

RESULTS:

Patients in the highest quartile for baseline FGF23 level had a higher rate of increase in htTKV (0.95% per year, P = 0.0016), and faster rate of decline in GFR (difference of -1.03 ml/min/1.73 m2 per year, P = 0.005) compared with the lowest quartile, after adjusting for other covariates, including htTKV and genotype. The highest quartile of FGF23 was also associated with a substantial increase in risk for the composite endpoint of ESRD, death, or doubling of serum creatinine (hazard ratio [HR] of 2.45 in the fully adjusted model, P = 0.03).

CONCLUSION:

FGF23 is a prognostic biomarker for disease progression and clinically important outcomes in ADPKD, and has additive value to established imaging and genetic biomarkers.

• Authors: Mireille El Ters, Pengcheng Lu, Jonathan D Mahnken, Jason R Stubbs, Shiqin Zhang, Darren P Wallace, Jared J Grantham, Arlene B Chapman, Vicente E Torres, Peter C Harris, Kyongtae Ty Bae, Douglas P Landsittel, Frederic F Rahbari-Oskoui, Michal Mrug, William M Bennett, Alan S L Yu
• Journal: Kidney international reports (Kidney Int Rep) Vol. 6 Issue 4 Pg. 953-961 (Apr 2021) ISSN: 2468-0249 [Electronic] United States
• PMID: 33912745 (Publication Type: Journal Article)
• Copyright: © 2021 International Society of Nephrology. Published by Elsevier Inc.