High FGF23 Increases Fall Risk in CKD

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Highest vs lowest quartile of intact fibroblast growth factor 23 is associated with a 2-fold greater risk of a first fall in older patients.
Highest vs lowest quartile of intact fibroblast growth factor 23 is associated with a 2-fold greater risk of a first fall in older patients.
The following article is part of conference coverage from Kidney Week 2018 in San Diego 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 2018.

SAN DIEGO—High levels of fibroblast growth factor 23 (FGF23) are associated with an increased risk of falls in patients with chronic kidney disease (CKD), according to study findings presented at the American Society of Nephrology's Kidney Week 2018 meeting.

The study, by Anna J. Jovanovich, MD, Assistant Professor of Medicine at the University of Colorado in Aurora, and colleagues, included 2488 participants in SPRINT (Systolic Blood Pressure Interventional Trial) with an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2. At baseline, the study population had a mean age of 73 years and mean eGFR of 49 mL/min/1.73 m2.

SPRINT was a randomized multicenter trial evaluating the effects of standard compared with intensive blood pressure lowering on cardiovascular outcomes among older individuals without diabetes.

After full adjustment, patients in the highest quartile of baseline intact FGF23 (iFGF23) had a significant 2-fold increased risk of a first fall compared with those in the lowest quartile. A doubling of iFGF23 was associated with a significant 2.3-fold increased risk of a first fall.

“Frailty and falls are associated among older adults and individuals with end-stage renal disease,” Dr Jovanovich told Renal & Urology News. “Although we did not test for frailty in our analysis, FGF23 could be a marker for frailty and falls in the CKD population.”

Dr Jovanovich's team obtained data on incident falls via a structured interview that occurred every 3 months. They recorded injurious falls as an adverse event if they were evaluated in the emergency department or required hospitalization.


Visit Renal & Urology News' conference section for continuous coverage from Kidney Week 2018.

Reference

Jovanovich AJ, Ginsberg C, You Z, et al. FGF23 and falls in SPRINT. Presented at the American Society of Nephrology's Kidney Week 2018 meeting in San Diego, Oct. 23-28. Abstract TH-OR021.

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