HD Patients with Lowest FGF-23 Level Have Lowest Survival Rate

Cumulative 2-year survival rate was 65.4%, 78.9%, 85.1%, and 80.6% among patients in the 1st, 2nd, 3rd, and 4th quartiles.
Cumulative 2-year survival rate was 65.4%, 78.9%, 85.1%, and 80.6% among patients in the 1st, 2nd, 3rd, and 4th quartiles.

SAN DIEGO—Fibroblast growth factor 23 (FGF-23) levels in the lowest quartile are associated with lowest 2-year cumulative survival rate among maintenance hemodialysis (MHD) patients, study findings presented at Kidney Week 2015 suggest.

Sonoo Mizuiri, MD, PhD, of Ichiyoukai Harada Hospital in Hiroshima, Japan, and colleagues examined serum intact FGF-23, age, dialysis vintage, presence of diabetes, and other clinical parameters in 332 MHD patients in September of 2012, 2013, and 2014. They measured coronary artery calcification (CAC) scores in a subgroup of 173 patients.

Patients had a median age of 69 years and dialysis vintage of 66 months at baseline, according to the researchers. Over 2 years, 71 patients died and 24 left their hospital. At baseline, FGF-23 levels in quartiles 1, 2, 3, and 4 were less than 310, 310–1,489, 1,490–5,294, and greater than 5,294 pg/mL, respectively. Cumulative survival rates among patients in these quartiles were 65.4%, 78.9%, 85.1%, and 80.6%, respectively. In multivariate analysis, the researchers found no significant association between FGF-23 quartile and mortality. Factors significantly associated with the lowest quartile of FGF-23 level were diabetes, age, serum phosphate level, and active vitamin D dosage. The investigators observed no significant differences in CAC score based on FGF-23 level.

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