Cargando…
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...
Autores principales: | , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1782217395708887040 |
---|---|
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. |
format | Online Article Text |
id | pubmed-3224491 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Springer |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT zhangmaryann fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT hsuraymond fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT hsuchiyuan fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT kordeschkristina fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT nicasioerica fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT cortezalfredo fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT mcalpineian fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT bradysandra fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT zhuohanjing fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT kangelariskirstenn fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT steinjohn fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT calfeecarolyns fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy AT liukathleend fgf23andpthlevelsinpatientswithacutekidneyinjuryacrosssectionalcaseseriesstudy |