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- Title
Fibroblast growth factor-23 and chronic allograft injury in pediatric renal transplant recipients: a Midwest Pediatric Nephrology Consortium study.
- Authors
Seifert, Michael E.; Ashoor, Isa F.; Chiang, Myra L.; Chishti, Aftab S.; Dietzen, Dennis J.; Gipson, Debbie S.; Janjua, Halima S.; Selewski, David T.; Hruska, Keith A.
- Abstract
The chronic kidney disease-mineral bone disorder ( CKD- MBD) produces fibroblast growth factor-23 ( FGF-23) and related circulating pathogenic factors that are strongly associated with vascular injury and declining kidney function in native CKD. Similarly, chronic renal allograft injury ( CRAI) is characterized by vascular injury and declining allograft function in transplant CKD. We hypothesized that circulating CKD- MBD factors could serve as non-invasive biomarkers of CRAI. We conducted a cross-sectional, multicenter case-control study. Cases (n = 31) had transplant function >20 mL/min/1.73 m2 and biopsy-proven CRAI. Controls (n = 31) had transplant function >90 mL/min/1.73 m2 and/or a biopsy with no detectable abnormality in the previous six months. We measured plasma CKD- MBD factors at a single time point using ELISA. Median (range) FGF23 levels were over twofold higher in CRAI vs. controls [106 (10-475) pg/mL vs. 45 (8-91) pg/mL; p < 0.001]. FGF23 levels were inversely correlated with transplant function (r2 = −0.617, p < 0.001). Higher FGF23 levels were associated with increased odds of biopsy-proven CRAI after adjusting for transplant function, clinical, and demographic factors [ OR (95% CI) 1.43 (1.23, 1.67)]. Relationships between additional CKD- MBD factors and CRAI were attenuated in multivariable models. Higher FGF23 levels were independently associated with biopsy-proven CRAI in children.
- Subjects
FIBROBLAST growth factors; HOMOGRAFTS; TRANSPLANTATION of organs, tissues, etc. in children; CHRONIC kidney failure in children; BONE diseases in children; KIDNEY transplant patients
- Publication
Pediatric Transplantation, 2016, Vol 20, Issue 3, p378
- ISSN
1397-3142
- Publication type
Article
- DOI
10.1111/petr.12682