Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease
Abstract Fibroblast growth factor-23 (FGF23) is an established biomarker of adverse outcomes in patients with chronic kidney disease (CKD). Several cross-sectional studies have suggested a possible association between FGF23 and anemia in these patients. In this large-scale prospective cohort study,...
| Main Authors: | , , , , , , , , , , , , , , |
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Nature Portfolio
2018-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-018-25439-z |
| _version_ | 1818856109011632128 |
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| author | Ki Heon Nam Hyoungnae Kim Seong Yeong An Misol Lee Min-Uk Cha Jung Tak Park Tae-Hyun Yoo Kyu-Beck Lee Yeong-Hoon Kim Su-Ah Sung Joongyub Lee Shin-Wook Kang Kyu Hun Choi Curie Ahn Seung Hyeok Han |
| author_facet | Ki Heon Nam Hyoungnae Kim Seong Yeong An Misol Lee Min-Uk Cha Jung Tak Park Tae-Hyun Yoo Kyu-Beck Lee Yeong-Hoon Kim Su-Ah Sung Joongyub Lee Shin-Wook Kang Kyu Hun Choi Curie Ahn Seung Hyeok Han |
| author_sort | Ki Heon Nam |
| collection | DOAJ |
| description | Abstract Fibroblast growth factor-23 (FGF23) is an established biomarker of adverse outcomes in patients with chronic kidney disease (CKD). Several cross-sectional studies have suggested a possible association between FGF23 and anemia in these patients. In this large-scale prospective cohort study, we investigated this relationship and examined whether high FGF23 levels increase the risk of incident anemia. This prospective longitudinal study included 2,089 patients from the KoreaN cohort study for Outcome in patients With CKD. Anemia was defined as hemoglobin level <13.0 g/dl (men) and <12.0 g/dl (women). Log-transformed FGF23 significantly correlated with hepcidin but inversely correlated with iron profiles and hemoglobin. Multivariate logistic regression showed that log-transformed FGF23 was independently associated with anemia (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.04–1.24, P = 0.01). Among 1,164 patients without anemia at baseline, 295 (25.3%) developed anemia during a median follow-up of 21 months. In fully adjusted multivariable Cox models, the risk of anemia development was significantly higher in the third (hazard ratio [HR], 1.66; 95% CI, 1.11–2.47; P = 0.01) and fourth (HR, 1.84; 95% CI, 1.23–2.76; P = 0.001) than in the first FGF23 quartile. In conclusion, high serum FGF23 levels were associated with an increased risk for anemia in patients with nondialysis CKD. |
| first_indexed | 2024-12-19T08:19:16Z |
| format | Article |
| id | doaj.art-48611d3684df48dc901ec99d0869807d |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-19T08:19:16Z |
| publishDate | 2018-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-48611d3684df48dc901ec99d0869807d2022-12-21T20:29:26ZengNature PortfolioScientific Reports2045-23222018-05-018111010.1038/s41598-018-25439-zCirculating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney DiseaseKi Heon Nam0Hyoungnae Kim1Seong Yeong An2Misol Lee3Min-Uk Cha4Jung Tak Park5Tae-Hyun Yoo6Kyu-Beck Lee7Yeong-Hoon Kim8Su-Ah Sung9Joongyub Lee10Shin-Wook Kang11Kyu Hun Choi12Curie Ahn13Seung Hyeok Han14Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung HospitalDepartment of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje UniversityDepartment of Internal Medicine, Eulji General Hospital, Eulji School of MedicineMedical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of MedicineDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei UniversityAbstract Fibroblast growth factor-23 (FGF23) is an established biomarker of adverse outcomes in patients with chronic kidney disease (CKD). Several cross-sectional studies have suggested a possible association between FGF23 and anemia in these patients. In this large-scale prospective cohort study, we investigated this relationship and examined whether high FGF23 levels increase the risk of incident anemia. This prospective longitudinal study included 2,089 patients from the KoreaN cohort study for Outcome in patients With CKD. Anemia was defined as hemoglobin level <13.0 g/dl (men) and <12.0 g/dl (women). Log-transformed FGF23 significantly correlated with hepcidin but inversely correlated with iron profiles and hemoglobin. Multivariate logistic regression showed that log-transformed FGF23 was independently associated with anemia (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.04–1.24, P = 0.01). Among 1,164 patients without anemia at baseline, 295 (25.3%) developed anemia during a median follow-up of 21 months. In fully adjusted multivariable Cox models, the risk of anemia development was significantly higher in the third (hazard ratio [HR], 1.66; 95% CI, 1.11–2.47; P = 0.01) and fourth (HR, 1.84; 95% CI, 1.23–2.76; P = 0.001) than in the first FGF23 quartile. In conclusion, high serum FGF23 levels were associated with an increased risk for anemia in patients with nondialysis CKD.https://doi.org/10.1038/s41598-018-25439-z |
| spellingShingle | Ki Heon Nam Hyoungnae Kim Seong Yeong An Misol Lee Min-Uk Cha Jung Tak Park Tae-Hyun Yoo Kyu-Beck Lee Yeong-Hoon Kim Su-Ah Sung Joongyub Lee Shin-Wook Kang Kyu Hun Choi Curie Ahn Seung Hyeok Han Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease Scientific Reports |
| title | Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease |
| title_full | Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease |
| title_fullStr | Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease |
| title_full_unstemmed | Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease |
| title_short | Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease |
| title_sort | circulating fibroblast growth factor 23 levels are associated with an increased risk of anemia development in patients with nondialysis chronic kidney disease |
| url | https://doi.org/10.1038/s41598-018-25439-z |
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