Elevated fibroblast growth factor 23 (FGF-23) is an independent risk factor for mortality and graft loss in renal transplant recipients, study findings suggest.

Overall, each standard deviation (SD) increment in log FGF-23 was associated with a 1.46 times increased risk of the composite outcome of all-cause mortality and allograft loss, after adjusting for potential confounders, according to an online report in the Journal of the American Society of Nephrology.

Among patients in the second and third tertile of FGF-23, each SD increment was associated with a 1.39 and 2.27 times increased risk compared with patients in the first tertile. The results were similar for each component of the composite outcome, the researchers noted.

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The study, which included 984 stable renal transplant patients who had a mean estimated glomerular filtration rate (eGFR) of 51 mL/min/1.73 m2 at enrollment, showed that other measures phosphorus metabolism, including serum phosphate and parathyroid hormone, did not consistently associate with outcomes.

“Although FGF-23, PTH, and serum phosphate are all physiologically interrelated, and each correlated significantly with eGFR, only FGF-23 emerged as a robust independent risk factor for mortality and allograft loss,” the authors, led by Myles Wolf, MD, of the University of Miami, wrote.