Elevated levels of fibroblast growth factor 23 (FGF-23) is an independent risk factor for end-stage renal disease (ESRD) in patients with relatively preserved kidney function and for mortality across the spectrum of chronic kidney disease (CKD), according to a prospective study published in the Journal of the American Medical Association (2011;305;2432-2439).
The study evaluated 3,879 enrollees in the Chronic Renal Insufficiency Cohort who had CKD stages 2-4. During a median follow-up of 3.5 years, 266 participants died and 410 reached ESRD. Median FGF-23 levels were significantly higher in both groups than in patients who remained event-free.
Patients in the highest compared with the lowest quartile had a 4.3-fold greater risk of death, with the intermediate quartiles associated with intermediate risks. In fully adjusted models, the graded increase in mortality persisted across the spectrum of FGF-23 levels.