Anemia Linked to High FGF23 Levels in CKD Patients

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CKD patients in the 3rd and 4th quartiles of c-terminal serum fibroblast growth factor 23 had a 74% and 73% higher risk for anemia compared with those in the 1st quartile.
CKD patients in the 3rd and 4th quartiles of c-terminal serum fibroblast growth factor 23 had a 74% and 73% higher risk for anemia compared with those in the 1st quartile.
The following article is part of conference coverage from Kidney Week 2017 in New Orleans hosted by the American Society of Nephrology. Renal & Urology News staff will be reporting live on medical studies conducted by nephrologists and other specialists who are tops in their field in acute kidney injury, chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from Kidney Week 2017.

NEW ORLEANS—High levels of c-terminal serum fibroblast growth factor 23 (cFGF23) predict greater risk for anemia in patients with chronic kidney disease (CKD), a team from Yonsei University in Seoul, Korea, reported Friday at the American Society of Nephrology's Kidney Week 2017 meeting.

"We believe that our findings are of great clinical importance and make a significant contribution to the literature,” co-investigator Seung Hyeok Han, MD, PhD, from Yonsei University in Seoul, Korea, told Renal & Urology News. “Anemia is a common complication in patients with CKD and is associated with adverse outcomes. Although there are well-established risk factors, this study suggests that FGF23 can also be a useful biomarker for incident anemia in patients with non-dialysis CKD.”

At study initiation, the researchers documented anemia in 925 of 2089 patients (mean age 53.6 years; 61% male) with non-dialysis CKD enrolled in KNOW-CKD (KoreaN cohort study for Outcome in patients With Chronic Kidney Disease).

During a median follow-up of 21 months, anemia developed in 295 of the remaining 1164 patients without baseline anemia. In a fully adjusted multivariable Cox model, patients in the 3rd and 4th quartiles of cFGF23 had a significant 74% and 73% increased risk for anemia, respectively, compared with those in the 1st quartile. The association held when cFGF23 was studied as a continuous variable.

A graph of log cFGF23 correlated significantly with lower iron and hemoglobin values. Moreover, as cFGF23 levels increased, levels of the peptide hormone hepcidin, a possible marker of decreased iron absorption and impaired iron release, also increased. Log cFGF23 was independently associated with anemia, according to a multivariate logistic regression model.


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Reference

1. Nam KH, An SY, Jhee JH, et al. Serum fibroblast growth factor-23 levels are associated with an increased risk of developing anemia in patients with non-dialysis CKD. Presented in format at Kidney Week 2017 in New Orleans (Oct. 31 to Nov. 5). Abstract FR-PO523.

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