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C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival
BACKGROUND: Increased fibroblast growth factor 23 (FGF23) is a risk factor for mortality, cardiovascular disease, and progression of chronic kidney disease. Limited data exist comparing the association of either c-terminal FGF23 (cFGF23) or intact FGF23 (iFGF23) in kidney transplant recipients (KTRs...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033679/ https://www.ncbi.nlm.nih.gov/pubmed/33832449 http://dx.doi.org/10.1186/s12882-021-02329-7 |
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author | Chu, Chang Elitok, Saban Zeng, Shufei Xiong, Yingquan Hocher, Carl-Friedrich Hasan, Ahmed A. Krämer, Bernhard K. Hocher, Berthold |
author_facet | Chu, Chang Elitok, Saban Zeng, Shufei Xiong, Yingquan Hocher, Carl-Friedrich Hasan, Ahmed A. Krämer, Bernhard K. Hocher, Berthold |
author_sort | Chu, Chang |
collection | PubMed |
description | BACKGROUND: Increased fibroblast growth factor 23 (FGF23) is a risk factor for mortality, cardiovascular disease, and progression of chronic kidney disease. Limited data exist comparing the association of either c-terminal FGF23 (cFGF23) or intact FGF23 (iFGF23) in kidney transplant recipients (KTRs) with overall (all-cause) graft loss. METHODS: We conducted a prospective observational cohort study in 562 stable kidney transplant recipients. Patients were followed for graft loss and all-cause mortality for a median follow-up of 48 months. RESULTS: During a median follow-up of 48 months, 94 patients had overall graft loss (primary graft loss or death with functioning graft). Both cFGF23 and iFGF23 concentrations were significantly higher in patients with overall graft loss than those without (24.59 [11.43–87.82] versus 10.67 [5.99–22.73] pg/ml; p < 0.0001 and 45.24 [18.63–159.00] versus 29.04 [15.23–60.65] pg/ml; p = 0.002 for cFGF23 and iFGF23, respectively). Time-dependent ROC analysis showed that cFGF23 concentrations had a better discriminatory ability than iFGF23 concentrations in predicting overall (all-cause) graft loss. Cox regression analyses adjusted for risk factors showed that cFGF23 (HR for one unit increase of log transformed cFGF23: 1.35; 95% CI, 1.01–1.79; p = 0.043) but not iFGF23 (HR for one unit increase of log transformed iFGF23: 0.97; 95% CI, 0.75–1.25; p = 0.794) was associated with the overall graft loss. CONCLUSION: Elevated cFGF23 concentrations at baseline are independently associated with an increased risk of overall graft loss. iFGF23 measurements were not independently associated with overall graft loss. The cFGF23 ELISA might detect bioactive FGF23 fragments that are not detected by the iFGF23 ELISA. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-021-02329-7. |
format | Online Article Text |
id | pubmed-8033679 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80336792021-04-09 C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival Chu, Chang Elitok, Saban Zeng, Shufei Xiong, Yingquan Hocher, Carl-Friedrich Hasan, Ahmed A. Krämer, Bernhard K. Hocher, Berthold BMC Nephrol Research Article BACKGROUND: Increased fibroblast growth factor 23 (FGF23) is a risk factor for mortality, cardiovascular disease, and progression of chronic kidney disease. Limited data exist comparing the association of either c-terminal FGF23 (cFGF23) or intact FGF23 (iFGF23) in kidney transplant recipients (KTRs) with overall (all-cause) graft loss. METHODS: We conducted a prospective observational cohort study in 562 stable kidney transplant recipients. Patients were followed for graft loss and all-cause mortality for a median follow-up of 48 months. RESULTS: During a median follow-up of 48 months, 94 patients had overall graft loss (primary graft loss or death with functioning graft). Both cFGF23 and iFGF23 concentrations were significantly higher in patients with overall graft loss than those without (24.59 [11.43–87.82] versus 10.67 [5.99–22.73] pg/ml; p < 0.0001 and 45.24 [18.63–159.00] versus 29.04 [15.23–60.65] pg/ml; p = 0.002 for cFGF23 and iFGF23, respectively). Time-dependent ROC analysis showed that cFGF23 concentrations had a better discriminatory ability than iFGF23 concentrations in predicting overall (all-cause) graft loss. Cox regression analyses adjusted for risk factors showed that cFGF23 (HR for one unit increase of log transformed cFGF23: 1.35; 95% CI, 1.01–1.79; p = 0.043) but not iFGF23 (HR for one unit increase of log transformed iFGF23: 0.97; 95% CI, 0.75–1.25; p = 0.794) was associated with the overall graft loss. CONCLUSION: Elevated cFGF23 concentrations at baseline are independently associated with an increased risk of overall graft loss. iFGF23 measurements were not independently associated with overall graft loss. The cFGF23 ELISA might detect bioactive FGF23 fragments that are not detected by the iFGF23 ELISA. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-021-02329-7. BioMed Central 2021-04-08 /pmc/articles/PMC8033679/ /pubmed/33832449 http://dx.doi.org/10.1186/s12882-021-02329-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Chu, Chang Elitok, Saban Zeng, Shufei Xiong, Yingquan Hocher, Carl-Friedrich Hasan, Ahmed A. Krämer, Bernhard K. Hocher, Berthold C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival |
title | C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival |
title_full | C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival |
title_fullStr | C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival |
title_full_unstemmed | C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival |
title_short | C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival |
title_sort | c-terminal and intact fgf23 in kidney transplant recipients and their associations with overall graft survival |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033679/ https://www.ncbi.nlm.nih.gov/pubmed/33832449 http://dx.doi.org/10.1186/s12882-021-02329-7 |
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