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- Title
Relationship of FGF23 to indexed left ventricular mass in children with non-dialysis stages of chronic kidney disease.
- Authors
Sinha, Manish; Turner, Charles; Booth, Caroline; Waller, Simon; Rasmussen, Pernille; Goldsmith, David; Simpson, John
- Abstract
Background: The aim of this study was to evaluate the association of serum intact fibroblast growth factor 23 (FGF23) concentrations with indexed left ventricular mass in children with non-dialysis stages 3-5 of chronic kidney disease (CKD). Methods: The study cohort comprised 83 children (51 boys; mean age 12.1 ± 3.2 years) with a mean estimated glomerular filtration rate (eGFR) of 32.3 ± 14.6 ml/min/1.73 m who underwent clinic and ambulatory blood pressure measurement (ABPM), echocardiography and evaluation of biochemical markers of CKD-associated mineral bone disease. Results: The mean left ventricular mass index (LVMI) was 35.9 ± 8.5 g/m (± standard deviation), with 30 (36.1 %) children showing left ventricular hypertrophy (LVH), all eccentric, as defined using age-specific criteria. For all subjects, the mean FGF23 concentration was 142.2 ± 204.4 ng/l and the normalised distribution following log transformation was 1.94 ± 0.39. There was significant univariate correlation of LVMI with GFR, body mass index (BMI) z-score and calcium intake, but not with 24-h systolic ABPM z-score, log intact parathyroid hormone or log FGF23. On multivariate analysis following adjustment for confounders, only elemental calcium content (g/kg/day) estimated from prescribed calcium-based phosphate binder dose (β = 154.9, p < 0.001) and BMI z-score (β = 2.397, p = 0.003) maintained a significant positive relationship with LVMI (model r = 0.225). Conclusions: We observed no significant relationship of FGF23 with LVMI. Larger studies in children are needed to clarify the roles of calcium-containing phosphate binders and FGF23 with LV mass and their roles in the evolution of the development of adverse cardiovascular outcomes.
- Subjects
HEART physiology; LEFT heart ventricle; ANTHROPOMETRY; BIOMARKERS; CARDIOVASCULAR diseases risk factors; CHI-squared test; CHRONIC kidney failure; ECHOCARDIOGRAPHY; ELECTRONYSTAGMOGRAPHY; FIBROBLASTS; FISHER exact test; GROWTH factors; HYPERTENSION; MULTIVARIATE analysis; SCIENTIFIC observation; PHYSICAL diagnosis; REGRESSION analysis; RESEARCH funding; SPHYGMOMANOMETERS; T-test (Statistics); DESCRIPTIVE statistics
- Publication
Pediatric Nephrology, 2015, Vol 30, Issue 10, p1843
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-015-3125-3