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Relationship Between Residual Renal Function and Serum Fibroblast Growth Factor 23 in Patients on Peritoneal Dialysis
Author(s) -
Yamada Shunsuke,
Tsuruya Kazuhiko,
Taniguchi Masatomo,
Yoshida Hisako,
Tokumoto Masanori,
Hasegawa Shoko,
Tanaka Shigeru,
Eriguchi Masahiro,
Nakano Toshiaki,
Kitazono Takanari
Publication year - 2014
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12170
Subject(s) - medicine , renal function , peritoneal dialysis , fibroblast growth factor 23 , urology , creatinine , endocrinology , interquartile range , hypophosphatemia , urine , dialysis , gastroenterology , parathyroid hormone , calcium
Fibroblast growth factor 23 ( FGF 23) levels in dialysis patients are influenced by various factors, including phosphorus load. However, the clinical parameters that determine serum FGF 23 levels in patients on peritoneal dialysis ( PD ) remain unclear. The aim of the present study was to examine the effects of clinical factors, on serum FGF 23 levels, with an emphasis on residual renal function ( RRF ). This cross‐sectional study included 56 outpatients undergoing PD therapy. Urine volume ≥100 mL/day or renal creatinine ( C r) clearance was used as a surrogate marker for RRF . Clinical characteristics were compared between patients with and without RRF . Linear regression analysis was conducted with serum FGF 23 level as the dependent variable and renal C r clearance as the main independent variable. The median and interquartile range of serum FGF 23 levels were 5970 (1451–11 688) pg/mL. Patients with RRF showed higher urinary and total phosphate eliminations, and lower serum FGF 23 and phosphate levels than patients without RRF . Multivariate linear regression analysis showed that the renal C r clearance and serum phosphate and dialysis history were negatively associated with serum FGF 23 levels, even after adjusting for potential confounders including peritoneal C r clearance. Further, the predictabilities of serum FGF 23 were comparable among renal C r clearance, K t/ V for urea, and renal phosphate clearance. RRF determined by renal C r clearance or residual urine volume is an independent negative determinant of serum FGF 23 levels in PD patients.