The Change of Serum FGF-23 Levels Predicts the Progression of Renal Function in Chronic Kidney Disease Patients
Kullaya Takkavatakarn, MD¹, Winat Kaewtan, MD¹, Api Chewcharat, MD¹, Kearkiat Praditpornsilpa, MD¹, Somchai Eiam-Ong, MD¹, Paweena Susantitaphong, MD, PhD¹
Affiliation : ¹ Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
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.
Received 9 August 2019 | Revised 4 November 2019 | Accepted 11 November 2019
doi.org/10.35755/jmedassocthai.2020.11.10515
Keywords : FGF-23, Vitamin D, CKD progression, Biomarker
