PMID- 25185018 OWN - NLM STAT- MEDLINE DCOM- 20161214 LR - 20211203 IS - 1718-4304 (Electronic) IS - 0896-8608 (Print) IS - 0896-8608 (Linking) VI - 36 IP - 1 DP - 2016 Jan-Feb TI - Baseline FGF23 is Associated with Cardiovascular Outcome in Incident PD Patients. PG - 26-32 LID - 10.3747/pdi.2013.00343 [doi] AB - diamond BACKGROUND: Fibroblast growth factor 23 (FGF23) is a phosphate regulating protein. Several studies demonstrated that elevated FGF23 is independently associated with mortality for early-stage chronic kidney disease and incident hemodialysis (HD) patients. However, little is known about the significance of elevated FGF23 in peritoneal dialysis (PD) patients. Here, we analyzed the association of FGF23 with cardiovascular (CV) events, all-cause mortality, residual renal function (RRF), and CV parameters in PD patients. diamond METHODS: The present study is a single-center, retrospective study. Patients who started PD at Seoul National University Hospital between January 2005 and July 2011 and whose baseline serum samples were available were enrolled. C-terminal FGF23 was measured. Subjects were divided into 2 groups; lower 2 tertiles (FGF23 119.0 RU/mL). The primary outcome was time to fatal or non-fatal CV events. In the subgroup analysis, the associations of FGF23 with aortic stiffness or with vascular calcification were analyzed. diamond RESULTS: A total of 205 incident PD patients were analyzed. Mean duration of follow-up was 41.6 +/- 20.0 months. The baseline median FGF23 level was 78.6 RU/mL (inter-quartile range [IQR], 34.1 - 155.0). At baseline, subjects in the higher FGF23 group were younger, and had a lower RRF, lower prevalence of diabetes mellitus (DM), and cerebrovascular disease. During follow-up, 22 of the 205 patients (10.7%) reached primary outcome. After adjustment for age, DM, pre-existing coronary artery disease, cerebrovascular disease, congestive heart failure, and left ventricular mass index, the higher FGF23 group exhibited significantly higher risk of primary outcome, compared with the lower group (hazard ratio [HR], 2.54; 95% confidence interval [CI], 1.05 - 6.12; p = 0.045). There were no significant differences in all-cause mortality and development of anuria between the 2 FGF23 groups. In the subgroup analysis, FGF23 groups were not associated with pulse wave velocity and abdominal aortic calcification score. diamond CONCLUSION: Elevated FGF23 is associated with higher risk of adverse CV outcome for incident PD patients. CI - Copyright (c) 2016 International Society for Peritoneal Dialysis. FAU - Kim, Hyo Jin AU - Kim HJ AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Park, Miseon AU - Park M AD - Clinical Research Institute, Seoul National University Hospital, Seoul, Korea. FAU - Park, Hayne Cho AU - Park HC AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Transplantation Research Institute, Seoul National University Hospital, Seoul, Korea. FAU - Jeong, Jong Cheol AU - Jeong JC AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Transplantation Research Institute, Seoul National University Hospital, Seoul, Korea. FAU - Kim, Dong Ki AU - Kim DK AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Joo, Kwon Wook AU - Joo KW AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Hwang, Young-Hwan AU - Hwang YH AD - Department of Internal Medicine, Eulji General Hospital, Eulji University, Seoul, Korea. FAU - Yang, Jaeseok AU - Yang J AD - Transplantation Center, Seoul National University Hospital, Seoul, Korea. FAU - Ahn, Curie AU - Ahn C AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Transplantation Research Institute, Seoul National University Hospital, Seoul, Korea. FAU - Oh, Kook-Hwan AU - Oh KH AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Clinical Research Institute, Seoul National University Hospital, Seoul, Korea khoh@snu.ac.kr. LA - eng PT - Journal Article DEP - 20140902 PL - United States TA - Perit Dial Int JT - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JID - 8904033 RN - 0 (FGF23 protein, human) RN - 62031-54-3 (Fibroblast Growth Factors) RN - 7Q7P4S7RRE (Fibroblast Growth Factor-23) SB - IM MH - Adult MH - Cardiovascular Diseases/*blood/*epidemiology/physiopathology MH - Cause of Death MH - Female MH - Fibroblast Growth Factor-23 MH - Fibroblast Growth Factors/*blood MH - Humans MH - Kidney/physiopathology MH - Male MH - Middle Aged MH - *Peritoneal Dialysis MH - Retrospective Studies PMC - PMC4737562 OTO - NOTNLM OT - FGF23 OT - Peritoneal dialysis OT - cardiovascular disease OT - fibroblast growth factor 23 EDAT- 2014/09/04 06:00 MHDA- 2016/12/15 06:00 PMCR- 2018/01/01 CRDT- 2014/09/04 06:00 PHST- 2014/05/14 00:00 [received] PHST- 2014/05/30 00:00 [accepted] PHST- 2014/09/04 06:00 [entrez] PHST- 2014/09/04 06:00 [pubmed] PHST- 2016/12/15 06:00 [medline] PHST- 2018/01/01 00:00 [pmc-release] AID - pdi.2013.00343 [pii] AID - 10.3747/pdi.2013.00343 [doi] PST - ppublish SO - Perit Dial Int. 2016 Jan-Feb;36(1):26-32. doi: 10.3747/pdi.2013.00343. Epub 2014 Sep 2.