Fibroblast growth factor 23 and left ventricular hypertrophy in dialyzed versus nondialyzed children with chronic kidney disease.

BACKGROUND

Fibroblast growth factor 23 (FGF23) is a protein encoded by the FGF23 gene in humans. It belongs to the FGF family, which plays a crucial role in phosphate and Vitamin D metabolism. The primary function of FGF23 appears to be regulating phosphate levels in plasma. Elevated FGF23 levels are consistently linked to left ventricular hypertrophy (LVH) and are a major risk factor for mortality in chronic kidney disease (CKD). We aimed to evaluate the role of FGF23 in assessing the association with LVH in dialyzed versus nondialyzed children with CKD.

PATIENTS AND

METHODS

This prospective observational study involved 50 children with CKD divided into two groups: Group I consisted of 34 subjects undergoing regular hemodialysis, whereas Group II included 16 subjects not on hemodialysis. Various tests were done, including serum creatinine, calcium, phosphorus, and FGF23, along with echocardiography.

RESULTS

There was a statistically significant increase in FGF23 levels in dialyzed compared to nondialyzed patients. A significant positive correlation was found between serum FGF-23 levels and the duration of dialysis and serum phosphorus. In addition, a positive correlation was observed between FGF23 and left ventricular mass (LVM), LVM index (LVMI), and relative wall thickness (RWT). The area under the curve of FGF23 for identifying LVH was 0.803, with a sensitivity of 85.7% and specificity of 63.9%.

CONCLUSIONS

Serum FGF-23 levels were significantly increased in dialyzed children compared to nondialyzed children. FGF-23 levels were significantly correlated with serum phosphorus levels, confirming the role of FGF23 in phosphate homeostasis. In addition, there were significant positive correlations between FGF23 levels and LVM, LVMI, and RWT, reinforcing FGF23's role in assessing the association with LVH.