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FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study

BACKGROUND: Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was...

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Autores principales: Zhang, MaryAnn, Hsu, Raymond, Hsu, Chi-yuan, Kordesch, Kristina, Nicasio, Erica, Cortez, Alfredo, McAlpine, Ian, Brady, Sandra, Zhuo, Hanjing, Kangelaris, Kirsten N, Stein, John, Calfee, Carolyn S, Liu, Kathleen D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224491/
https://www.ncbi.nlm.nih.gov/pubmed/21906363
http://dx.doi.org/10.1186/2110-5820-1-21
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author Zhang, MaryAnn
Hsu, Raymond
Hsu, Chi-yuan
Kordesch, Kristina
Nicasio, Erica
Cortez, Alfredo
McAlpine, Ian
Brady, Sandra
Zhuo, Hanjing
Kangelaris, Kirsten N
Stein, John
Calfee, Carolyn S
Liu, Kathleen D
author_facet Zhang, MaryAnn
Hsu, Raymond
Hsu, Chi-yuan
Kordesch, Kristina
Nicasio, Erica
Cortez, Alfredo
McAlpine, Ian
Brady, Sandra
Zhuo, Hanjing
Kangelaris, Kirsten N
Stein, John
Calfee, Carolyn S
Liu, Kathleen D
author_sort Zhang, MaryAnn
collection PubMed
description BACKGROUND: Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was to measure FGF-23 levels in critically ill patients with acute kidney injury to determine whether FGF-23 levels were elevated, as in chronic kidney disease. METHODS: Plasma FGF-23 and intact parathyroid hormone (PTH) levels were measured in 12 patients with acute kidney injury and 8 control subjects. RESULTS: FGF-23 levels were significantly higher in acute kidney injury cases than in critically ill subjects without acute kidney injury, with a median FGF-23 level of 1948 RU/mL (interquartile range (IQR), 437-4369) in cases compared with 252 RU/mL (IQR, 65-533) in controls (p = 0.01). No correlations were observed between FGF-23 and severity of acute kidney injury (defined by the Acute Kidney Injury Network criteria); among patients with acute kidney injury, FGF-23 levels were higher in nonsurvivors than survivors (median levels of 4446 RU/mL (IQR, 3455-5443) versus 544 RU/mL (IQR, 390-1948; p = 0.02). Severe hyperparathyroidism (defined as intact PTH >250 mg/dL) was present in 3 of 12 (25%) of the acute kidney injury subjects versus none of the subjects without acute kidney injury, although this result did not meet statistical significance. CONCLUSIONS: We provide novel data that demonstrate that FGF-23 levels are elevated in acute kidney injury, suggesting that FGF-23 dysregulation occurs in acute kidney injury as well as chronic kidney disease. Further studies are needed to define the short- and long-term clinical effects of dysregulated mineral metabolism in acute kidney injury patients.
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spelling pubmed-32244912011-12-16 FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study Zhang, MaryAnn Hsu, Raymond Hsu, Chi-yuan Kordesch, Kristina Nicasio, Erica Cortez, Alfredo McAlpine, Ian Brady, Sandra Zhuo, Hanjing Kangelaris, Kirsten N Stein, John Calfee, Carolyn S Liu, Kathleen D Ann Intensive Care Research BACKGROUND: Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was to measure FGF-23 levels in critically ill patients with acute kidney injury to determine whether FGF-23 levels were elevated, as in chronic kidney disease. METHODS: Plasma FGF-23 and intact parathyroid hormone (PTH) levels were measured in 12 patients with acute kidney injury and 8 control subjects. RESULTS: FGF-23 levels were significantly higher in acute kidney injury cases than in critically ill subjects without acute kidney injury, with a median FGF-23 level of 1948 RU/mL (interquartile range (IQR), 437-4369) in cases compared with 252 RU/mL (IQR, 65-533) in controls (p = 0.01). No correlations were observed between FGF-23 and severity of acute kidney injury (defined by the Acute Kidney Injury Network criteria); among patients with acute kidney injury, FGF-23 levels were higher in nonsurvivors than survivors (median levels of 4446 RU/mL (IQR, 3455-5443) versus 544 RU/mL (IQR, 390-1948; p = 0.02). Severe hyperparathyroidism (defined as intact PTH >250 mg/dL) was present in 3 of 12 (25%) of the acute kidney injury subjects versus none of the subjects without acute kidney injury, although this result did not meet statistical significance. CONCLUSIONS: We provide novel data that demonstrate that FGF-23 levels are elevated in acute kidney injury, suggesting that FGF-23 dysregulation occurs in acute kidney injury as well as chronic kidney disease. Further studies are needed to define the short- and long-term clinical effects of dysregulated mineral metabolism in acute kidney injury patients. Springer 2011-06-14 /pmc/articles/PMC3224491/ /pubmed/21906363 http://dx.doi.org/10.1186/2110-5820-1-21 Text en Copyright ©2011 Zhang et al; licensee Springer. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Zhang, MaryAnn
Hsu, Raymond
Hsu, Chi-yuan
Kordesch, Kristina
Nicasio, Erica
Cortez, Alfredo
McAlpine, Ian
Brady, Sandra
Zhuo, Hanjing
Kangelaris, Kirsten N
Stein, John
Calfee, Carolyn S
Liu, Kathleen D
FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study
title FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study
title_full FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study
title_fullStr FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study
title_full_unstemmed FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study
title_short FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study
title_sort fgf-23 and pth levels in patients with acute kidney injury: a cross-sectional case series study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224491/
https://www.ncbi.nlm.nih.gov/pubmed/21906363
http://dx.doi.org/10.1186/2110-5820-1-21
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