Fibroblast Growth Factor 23 and Risk of CKD Progression in Children

• DOI: 10.2215/cjn.02110216
• Publication Date: 2016-08-26T01:41:33Z
• Authors: Anthony A. Portale; Myles S. Wolf; Shari Messinger; Farzana Perwad; Harald Jüppner; Bradley A. Warady; Susan L. Furth; Isidro B. Salusky
• Keywords: Interquartile range

Background and objectives Plasma fibroblast growth factor 23 (FGF23) concentrations increase early in the course of CKD children. High FGF23 levels associate with progression adults. Whether predicts children is unknown. Design, setting, participants, & measurements We tested hypothesis that high plasma an independent risk for 419 children, aged 1–16 years, enrolled Chronic Kidney Disease Children (CKiD) cohort study. measured at baseline determined GFR annually using disappearance iohexol or CKiD study estimating equation. analyzed association to composite end point, defined as start dialysis kidney transplantation 50% decline from GFR, adjusted demographics, proteinuria, other CKD-specific factors, mineral metabolites. Results At enrollment, median age was 11 years [interquartile range (IQR), 8–15], 44 ml/min per 1.73 m 2 (IQR, 33–57), 132 RU/ml 88–200). During a follow-up 5.5 3.5–6.6), 32.5% reached point. Higher were independently associated higher outcome (fully hazard ratio, 2.52 highest versus lowest tertile; 95% confidence interval, 1.44 4.39, P =0.002; fully 1.33 doubling FGF23; 1.13 1.56, =0.001). The time 40% shorter participants compared tertile. In contrast, serum phosphorus, vitamin D metabolites, parathyroid hormone did not consistently analyses. Conclusions