The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans
Anemia in chronic kidney disease (CKD) is an almost universal complication of this condition. Fibroblast growth factor 23 (FGF23), a key-player in mineral metabolism, is reportedly associated with anemia and hemoglobin levels in non-dialysis CKD patients. Here, we sought to further characterize this...
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| Format: | Article |
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MDPI AG
2020-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/8/2640 |
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| author | Bernhard Bielesz Thomas Reiter Fabian Peter Hammerle Wolfgang Winnicki Marija Bojic Andreas Gleiss Heidi Kieweg Franz Ratzinger Gere Sunder-Plassmann Rodrig Marculescu |
| author_facet | Bernhard Bielesz Thomas Reiter Fabian Peter Hammerle Wolfgang Winnicki Marija Bojic Andreas Gleiss Heidi Kieweg Franz Ratzinger Gere Sunder-Plassmann Rodrig Marculescu |
| author_sort | Bernhard Bielesz |
| collection | DOAJ |
| description | Anemia in chronic kidney disease (CKD) is an almost universal complication of this condition. Fibroblast growth factor 23 (FGF23), a key-player in mineral metabolism, is reportedly associated with anemia and hemoglobin levels in non-dialysis CKD patients. Here, we sought to further characterize this association while taking into account the biologically active, intact fraction of FGF23, iron metabolism, and erythropoietin (EPO). Hemoglobin, EPO, iron, and mineral metabolism parameters, including both intact and c-terminal-FGF23 (iFGF23 and cFGF23, respectively) were measured cross-sectionally in 225 non-dialysis CKD patients (stage 1–5, median eGFR: 30 mL/min./1.73m<sup>2</sup>) not on erythropoiesis stimulating agents or intravenous iron therapy. Statistical analysis was performed by multiple linear regression. After adjustment for eGFR and other important confounders, only cFGF23 but not iFGF23 was significantly associated with hemoglobin levels and this association was largely accounted for by iron metabolism parameters. cFGF23 but not iFGF23 was also associated with mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV), again in dependence on iron metabolism parameters. Similarly, EPO concentrations were associated with cFGF23 but not iFGF23, but their contribution to the association of cFGF23 with hemoglobin levels was marginal. In pre-dialysis CKD patients, the observed association of FGF23 with hemoglobin seems to be restricted to cFGF23 and largely explained by the iron status. |
| first_indexed | 2024-03-10T17:27:16Z |
| format | Article |
| id | doaj.art-3b23fcc2d0874eeb8611cd7a75933f37 |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T17:27:16Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3b23fcc2d0874eeb8611cd7a75933f372023-11-20T10:07:28ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0198264010.3390/jcm9082640The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in HumansBernhard Bielesz0Thomas Reiter1Fabian Peter Hammerle2Wolfgang Winnicki3Marija Bojic4Andreas Gleiss5Heidi Kieweg6Franz Ratzinger7Gere Sunder-Plassmann8Rodrig Marculescu9Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaCenter for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, AustriaAnemia in chronic kidney disease (CKD) is an almost universal complication of this condition. Fibroblast growth factor 23 (FGF23), a key-player in mineral metabolism, is reportedly associated with anemia and hemoglobin levels in non-dialysis CKD patients. Here, we sought to further characterize this association while taking into account the biologically active, intact fraction of FGF23, iron metabolism, and erythropoietin (EPO). Hemoglobin, EPO, iron, and mineral metabolism parameters, including both intact and c-terminal-FGF23 (iFGF23 and cFGF23, respectively) were measured cross-sectionally in 225 non-dialysis CKD patients (stage 1–5, median eGFR: 30 mL/min./1.73m<sup>2</sup>) not on erythropoiesis stimulating agents or intravenous iron therapy. Statistical analysis was performed by multiple linear regression. After adjustment for eGFR and other important confounders, only cFGF23 but not iFGF23 was significantly associated with hemoglobin levels and this association was largely accounted for by iron metabolism parameters. cFGF23 but not iFGF23 was also associated with mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV), again in dependence on iron metabolism parameters. Similarly, EPO concentrations were associated with cFGF23 but not iFGF23, but their contribution to the association of cFGF23 with hemoglobin levels was marginal. In pre-dialysis CKD patients, the observed association of FGF23 with hemoglobin seems to be restricted to cFGF23 and largely explained by the iron status.https://www.mdpi.com/2077-0383/9/8/2640renal insufficiencychronicmineral metabolismanemia |
| spellingShingle | Bernhard Bielesz Thomas Reiter Fabian Peter Hammerle Wolfgang Winnicki Marija Bojic Andreas Gleiss Heidi Kieweg Franz Ratzinger Gere Sunder-Plassmann Rodrig Marculescu The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans Journal of Clinical Medicine renal insufficiency chronic mineral metabolism anemia |
| title | The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans |
| title_full | The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans |
| title_fullStr | The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans |
| title_full_unstemmed | The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans |
| title_short | The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans |
| title_sort | role of iron and erythropoietin in the association of fibroblast growth factor 23 with anemia in chronic kidney disease in humans |
| topic | renal insufficiency chronic mineral metabolism anemia |
| url | https://www.mdpi.com/2077-0383/9/8/2640 |
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