Single FGF23 Value Enough to Predict Cardiovascular Risk

A repeat measurement has no added prognostic value in CKD patients.
A repeat measurement has no added prognostic value in CKD patients.

A single measurement of fibroblast growth factor-23 (FGF23) is sufficient to predict cardiovascular event risk in patients with chronic kidney disease (CKD), according to a new study.

In routine clinical practice, the variability of FGF23 over two years is small, researchers reported in Nephrology Dialysis Transplantation (2014;29:88-97). “Concomitantly, this study showed no benefit of consecutive FGF23 testing for estimating the risk of a clinical event in an individual patient.”

The study, which confirmed that FGF23 is an important cardiovascular risk factor, examined whether repeated measurements of FGF23 after two years—which allowed calculation of time-averaged FGF23  levels and rate of change in FGF23 levels—enabled better prediction of clinical events in CKD than a single time point value.

The study included 429 patients (mean age 62 years) with a median glomerular filtration rate of 36 mL/min/1.73 m2. The study's primary outcome was a composite of myocardial infarction, stroke, and cardiovascular mortality.

“Although we expected that changing levels of FGF23 in the natural course of the disease will change outcome, this study provides no clear evidence for this,” Annet Bouma-de Krijger, MD, of VU University Medical Center in Amsterdam, The Netherlands, and colleagues wrote.

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