Relationship of FGF23 to indexed left ventricular mass in children with non-dialysis stages of chronic kidney disease.

Abstract

BACKGROUND:

The aim of this study was to evaluate the association of serum intact fibroblast growth factor 23 (FGF23) concentrations with indexed left ventricular mass in children with non-dialysis stages 3-5 of chronic kidney disease (CKD).

METHODS:

The study cohort comprised 83 children (51 boys; mean age 12.1 ± 3.2 years) with a mean estimated glomerular filtration rate (eGFR) of 32.3 ± 14.6 ml/min/1.73 m(2) who underwent clinic and ambulatory blood pressure measurement (ABPM), echocardiography and evaluation of biochemical markers of CKD-associated mineral bone disease.

RESULTS:

The mean left ventricular mass index (LVMI) was 35.9 ± 8.5 g/m(2.7) (± standard deviation), with 30 (36.1 %) children showing left ventricular hypertrophy (LVH), all eccentric, as defined using age-specific criteria. For all subjects, the mean FGF23 concentration was 142.2 ± 204.4 ng/l and the normalised distribution following log transformation was 1.94 ± 0.39. There was significant univariate correlation of LVMI with GFR, body mass index (BMI) z-score and calcium intake, but not with 24-h systolic ABPM z-score, log intact parathyroid hormone or log FGF23. On multivariate analysis following adjustment for confounders, only elemental calcium content (g/kg/day) estimated from prescribed calcium-based phosphate binder dose (β = 154.9, p < 0.001) and BMI z-score (β = 2.397, p = 0.003) maintained a significant positive relationship with LVMI (model r (2) = 0.225).

CONCLUSIONS:

We observed no significant relationship of FGF23 with LVMI. Larger studies in children are needed to clarify the roles of calcium-containing phosphate binders and FGF23 with LV mass and their roles in the evolution of the development of adverse cardiovascular outcomes.

• Authors: Manish D Sinha, Charles Turner, Caroline J Booth, Simon Waller, Pernille Rasmussen, David J A Goldsmith, John M Simpson
• Journal: Pediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 30 Issue 10 Pg. 1843-52 (Oct 2015) ISSN: 1432-198X [Electronic] Germany
• PMID: 25975437 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• FGF23 protein, human
• Fibroblast Growth Factors
• Fibroblast Growth Factor-23
• Creatinine

Topics

• Adolescent
• Biomarkers (blood)
• Blood Pressure (physiology)
• Child
• Child, Preschool
• Creatinine (blood)
• Cross-Sectional Studies
• Disease Progression
• Echocardiography
• Enzyme-Linked Immunosorbent Assay
• Female
• Fibroblast Growth Factor-23
• Fibroblast Growth Factors (blood)
• Glomerular Filtration Rate
• Heart Ventricles (diagnostic imaging)
• Humans
• Hypertrophy, Left Ventricular (blood, diagnostic imaging, etiology)
• Male
• Renal Dialysis
• Renal Insufficiency, Chronic (complications, diagnosis, metabolism)
• Severity of Illness Index