Patients on hemodialysis (HD) who have high levels of fibroblast growth factor 23 (FGF23) are at increased risks for death and cardiovascular events, according to study findings published in Blood Purification.

In meta-analyses of 7 prospective cohort studies of 2014 patients on HD (45% female; mean age 62 years), high levels of intact FGF23 (iFGF23) were significantly associated with a 14% excess risk for all-cause mortality compared with low levels. Likewise, high vs low C-terminal FGF23 (cFGF23) concentrations correlated with a significant 39% excess risk. Elevated levels of iFGF23 also correlated with a significant 21% increased risk for cardiovascular events. Previous research have demonstrated a relationship between cFGF23 and cardiovascular events. Overall, investigators determined that elevated FGF23 was associated with a 25% and 22% increased risk for death and cardiovascular events, respectively.

High FGF23 levels may increase the risks for all-cause mortality and cardiovascular disease and may be a useful predictor in clinical practice, Jinsheng Xu, MD, of the Fourth Hospital of Hebei Medical University in China, and colleagues, concluded. The precise mechanisms by which FGF23 leads to these increased risks are still unclear.

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Gao S, Xu J, Zhang S, Jin J. Meta-analysis of the association between fibroblast growth factor 23 and mortality and cardiovascular events in hemodialysis patients. Blood Purif. DOI: 10.1159/000496220