Background: The role of elevated baseline fibroblast growth factor 23 (FGF-23) levels on the progression of renal function in long term (years) follow-up studies is not yet established.

Objective: To circumvent the confounding factors occurring during the study duration, the authors examined the roles of the changing values of FGF-23 and other risk factors on progression of renal function after a shorter term (months) follow-up.

Materials and Methods: The present study was a 12-week prospective cohort study to determine the association between traditional and non-traditional risk factors on the progression of renal function.

Results: Sixty-five chronic kidney disease (CKD) patients were included. After a 12-week follow-up, significant increases of serum creatinine, cystatin C, vitamin D level, and FGF-23 levels were observed. The delta FGF-23 values increased progressively according to the staging of the CKD. The baseline parathyroid hormone level, which was in the recommended range following the KDIGO guideline, and the delta FGF-23 values were the significant parameters that had association with the decline of the estimated glomerular filtration. There was a positive association between delta FGF-23 and delta 25-OH vitamin D values.

Conclusion: The increasing change in serum FGF-23 level is significantly correlated with declining renal function. Thus, delta FGF-23 value could be utilized as a suitable biomarker for following and detecting CKD progression.

Keywords: FGF-23, Vitamin D, CKD progression, Biomarker

DOI: doi.org/10.35755/jmedassocthai.2020.11.10515

Received 9 August 2019 | Revised 4 November 2019 | Accepted 11 November 2019