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J Am Soc Nephrol. 2015 Jan;26(1):192-200. doi: 10.1681/ASN.2014020218. Epub 2014 Jul 24.

Serum fibroblast growth factor-23 is associated with incident kidney disease.

Author information

1
Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; crebhol1@jhu.edu.
2
Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Divisions of Nephrology and.
3
Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland;
4
William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts;
5
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland;
6
Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts;
7
Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, Minnesota;
8
Departments of Biostatistics and Epidemiology, and Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;
9
Division of Nephrology, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California; and.
10
Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.

Abstract

Fibroblast growth factor-23 is a bone-derived hormone that increases urinary phosphate excretion and inhibits hydroxylation of 25-hydroxyvitamin D. Recent studies suggest that fibroblast growth factor-23 may be an early biomarker of CKD progression. However, its role in kidney function decline in the general population is unknown. We assessed the relationship between baseline (1990-1992) serum levels of intact fibroblast growth factor-23 and incident ESRD in 13,448 Atherosclerosis Risk in Communities study participants (56.1% women, 74.7% white) followed until December 31, 2010. At baseline, the mean age of participants was 56.9 years and the mean eGFR was 97 ml/min per 1.73 m(2). During a median follow-up of 19 years, 267 participants (2.0%) developed ESRD. After adjustment for demographic characteristics, baseline eGFR, traditional CKD risk factors, and markers of mineral metabolism, the highest fibroblast growth factor-23 quintile (>54.6 pg/ml) compared with the lowest quintile (<32.0 pg/ml) was associated with risk of developing ESRD (hazard ratio, 2.10; 95% confidence interval, 1.31 to 3.36; trend P<0.001). In a large, community-based study comprising a broad range of kidney function, higher baseline fibroblast growth factor-23 levels were associated with increased risk of incident ESRD independent of the baseline level of kidney function and a number of other risk factors.

KEYWORDS:

ESRD; mineral metabolism; risk factors

PMID:
25060052
PMCID:
PMC4279743
DOI:
10.1681/ASN.2014020218
[Indexed for MEDLINE]
Free PMC Article

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