Introduction: Chronic kidney disease (CKD) is growing problem nowadays. Disorder of mineral metabolism occurs in initialCKD and includes the changes of bone metabolism. Fibroblast growth factor 23 (FGF23) plays an important role in phosphate metabolism. Bearing in mind this physiological role of FGF23, but also its role in pathophysiology of mineral and bone metabolism, there is a growing interest in conducting clinical studies in patients affected by CKD. Our aim was to investigate the potential relationship among FGF23 and other chronic kidney disease-mineral and bone disorder (CKD-MBD) participants in the clinical setting.
Methods: Eighty-seven CKD patients were involvedin our cross-sectional study, including all causes of the disease. The mean estimated glomerular filtration rate (eGFR) was 40.1 (3110) mL/min/1.73 m2. Evaluation of renal function and mineral methabolism condition were perfomed by using standard biochemical protocols. Serum intact FGF23 (iFGF23) level determination was accomplished by utilizing ELISAtechnique. The concentration of iFGF23 in serum greater than 50 ng/L was defined as elevated levels. Descriptive and analytical statistics were used to analyze the data acquired from the study.
Results: The mean iFGF23 level was 80.53±43.59 ng/L and was increased from CKD stage 1. Serum iFGF23 correlated negatively with eGFR (P<0.05) and positively with the levels of serum creatinine (P<0.05). Increased level of PTH was seen in stage 3 CKD. Hyperphosphatemia was present from stage 4 CKD, while serum calcium levels remained mostly in reference range. No correlation was seen between iFGF23 with serum calcium, phosphate and parathyroid hormone (PTH) levels.
Conclusion: Initial CKD shows elevated serum iFGF23 levels, whereas other CKD-MBD parameters are mostly within reference range. No significant association was seen between iFGF23 with other markers of CKD-MBD.
Keywords: iFGF23, mineral and bone disorder, CKD, biomarker
18 - 21 May 2019
European Society of Endocrinology