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Fibroblast growth factor 23 in untreated nephrotic syndrome
Author(s) -
Yadav Ashok Kumar,
Ramachandran Raja,
Aggarwal Abhinav,
Kumar Vinod,
Gupta Krishan Lal,
Jha Vivekanand
Publication year - 2018
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13001
Subject(s) - medicine , endocrinology , fibroblast growth factor 23 , nephrotic syndrome , vitamin d and neurology , parathyroid hormone , vitamin d deficiency , creatinine , bone remodeling , kidney disease , calcium
Aim Despite its importance in bone and cardiovascular disease in subjects with kidney disease, there are no data on fibroblast growth factor 23 (FGF23) perturbations in nephrotic syndrome. We evaluated FGF23 and markers of mineral bone metabolism in subjects with untreated NS. Methods In this cross‐sectional study, we measured circulating levels of FGF23, 25‐hydroxy vitamin D [25(OH)D], 1,25 di‐hydroxy vitamin D [1,25(OH) 2 D], serum albumin, serum calcium, phosphorus, creatinine and intact parathyroid hormone (iPTH) in 101 patients with adults onset NS and 40 healthy controls. We examined the correlation between FGF23 and markers of mineral bone metabolism. Results Compared to healthy controls, subjects with NS showed reduced levels of 25(OH)D (21.76 ± 10.18 vs 35.74 ± 40.27 nmol/L, P = 0.001), 1,25(OH) 2 D (median; 37.80 vs 73.13 pmol/L, P = 0.0001) and FGF23 (37.81 ± 20.42 vs 48.20 ± 11.60 pg/mL, P = 0.004) levels. Serum phosphorus levels were marginally, but significantly higher in subjects with nephrotic syndrome compared to healthy controls ( P = 0.004). Serum iPTH levels were significantly higher in subjects with NS compared to healthy controls (52.24 ± 39.58 vs 37.90 ± 14.60 pg/mL, P = 0.028). Conclusions We conclude that FGF23 is reduced in subjects with NS compared to healthy controls. The reduced levels of Vitamin D, and urinary losses may contribute to lower levels of FGF23 in NS.