Fibroblast growth-factor 23 and vitamin D are associated with iron deficiency and anemia in children with chronic kidney disease
Background This cross-sectional study investigates the association of fibroblast growth-factor 23 (FGF23) and other bone mineral parameters with iron status and anemia in pediatric chronic kidney disease (CKD). Methods Serum calcium, phosphorus, 25-hydroxyvitamin D (25(OH)D), intact parathormone, c-...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2023-08, Vol.38 (8), p.2771-2779 |
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| creator | Karava, Vasiliki Dotis, John Kondou, Antonia Christoforidis, Athanasios Taparkou, Anna Farmaki, Evangelia Economou, Marina Printza, Nikoleta |
| description | Background
This cross-sectional study investigates the association of fibroblast growth-factor 23 (FGF23) and other bone mineral parameters with iron status and anemia in pediatric chronic kidney disease (CKD).
Methods
Serum calcium, phosphorus, 25-hydroxyvitamin D (25(OH)D), intact parathormone, c-terminal FGF23, a-Klotho, iron (Fe), ferritin, unsaturated iron-binding capacity, and hemoglobin (Hb) were measured in 53 patients from 5 to 19 years old with GFR 100 ng/mL, TSAT ≤ 20%) were observed in 32% and 7.5% of patients, respectively. In CKD stages 3–4 (36 patients), lnFGF23 and 25(OH)D were correlated with Fe (rs = − 0.418,
p
= 0.012 and rs = 0.467,
p
= 0.005) and TSAT (rs = − 0.357,
p
= 0.035 and rs = 0.487,
p
= 0.003) but not to ferritin. In this patient group, lnFGF23 and 25(OH)D were correlated with Hb
z
-score (rs = − 0.649,
p
|
| doi_str_mv | 10.1007/s00467-023-05903-3 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2781618820</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A759337797</galeid><sourcerecordid>A759337797</sourcerecordid><originalsourceid>FETCH-LOGICAL-c511t-3c1557b3bcc4c2f071864635c9f37218d61709a10201c3ed5d6999aea3efba893</originalsourceid><addsrcrecordid>eNp9kk9rFTEUxQdR7LP6BVxIQBA3U_NnZpIsS7UqFNwodBcyyZ03qTNJTTItb-dHN-1Ua-UhWVzI_Z3D5XCq6iXBRwRj_i5h3HS8xpTVuJWY1exRtSENozWR4vxxtcGSkRo35PygepbSBcZYtKJ7Wh2wTnSUtmxT_Tx1fQz9pFNG2xiu81gP2uQQEWVIe4uuXNaz8-g90hGQTikYpzNYdO3yiFwMHlkYnHHgze5WoT3MTqOiMaObbAS_smYssDPou7Medsi6BDrB8-rJoKcEL-7mYfXt9MPXk0_12ZePn0-Oz2rTEpJrZkjb8p71xjSGDpgT0TUda40cGKdE2I5wLDXBFBPDwLa2k1Jq0AyGXgvJDqu3q-9lDD8WSFnNLhmYpnJuWJKiXJCOCEFxQV__g16EJfpynaKiaRpGWCvvqa2eQDk_hBy1uTFVx7zsGeeSF6reQ23BQ9RT8CW58v2AP9rDl2dLqGav4M1fghH0lMcUpiW74NNDkK6giSGlCIO6jG7WcacIVjd9UmufVOmTuu2TYkX06i6KpZ_B_pH8LlAB2AqksvJbiPdZ_cf2F97t0xk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2844431359</pqid></control><display><type>article</type><title>Fibroblast growth-factor 23 and vitamin D are associated with iron deficiency and anemia in children with chronic kidney disease</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Karava, Vasiliki ; Dotis, John ; Kondou, Antonia ; Christoforidis, Athanasios ; Taparkou, Anna ; Farmaki, Evangelia ; Economou, Marina ; Printza, Nikoleta</creator><creatorcontrib>Karava, Vasiliki ; Dotis, John ; Kondou, Antonia ; Christoforidis, Athanasios ; Taparkou, Anna ; Farmaki, Evangelia ; Economou, Marina ; Printza, Nikoleta</creatorcontrib><description>Background
This cross-sectional study investigates the association of fibroblast growth-factor 23 (FGF23) and other bone mineral parameters with iron status and anemia in pediatric chronic kidney disease (CKD).
Methods
Serum calcium, phosphorus, 25-hydroxyvitamin D (25(OH)D), intact parathormone, c-terminal FGF23, a-Klotho, iron (Fe), ferritin, unsaturated iron-binding capacity, and hemoglobin (Hb) were measured in 53 patients from 5 to 19 years old with GFR < 60 mL/min/1.73 m
2
. Transferrin saturation (TSAT) was calculated.
Results
Absolute (ferritin ≤ 100 ng/mL, TSAT ≤ 20%) and functional iron deficiency (ferritin > 100 ng/mL, TSAT ≤ 20%) were observed in 32% and 7.5% of patients, respectively. In CKD stages 3–4 (36 patients), lnFGF23 and 25(OH)D were correlated with Fe (rs = − 0.418,
p
= 0.012 and rs = 0.467,
p
= 0.005) and TSAT (rs = − 0.357,
p
= 0.035 and rs = 0.487,
p
= 0.003) but not to ferritin. In this patient group, lnFGF23 and 25(OH)D were correlated with Hb
z
-score (rs = − 0.649,
p
< 0.001 and rs = 0.358,
p
= 0.035). No correlation was detected between lnKlotho and iron parameters. In CKD stages 3–4, in multivariate backward logistic regression analysis, including bone mineral parameters, CKD stage, patient age, and daily alphacalcidol dose as covariates, lnFGF23 and 25(OH)D were associated with low TSΑΤ (15 patients) (OR 6.348, 95% CI 1.106–36.419, and OR 0.619, 95% CI 0.429–0.894, respectively); lnFGF23 was associated with low Hb (10 patients) (OR 5.747, 95% CI 1.270–26.005); while the association between 25(OH)D and low Hb did not reach statistical significance (OR 0.818, 95% CI 0.637–1.050).
Conclusions
In pediatric CKD stages 3–4, iron deficiency and anemia are associated with increased FGF23, independently of Klotho. Vitamin D deficiency might contribute to iron deficiency in this population.
Graphical abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information</description><identifier>ISSN: 0931-041X</identifier><identifier>ISSN: 1432-198X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-023-05903-3</identifier><identifier>PMID: 36862253</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>25-Hydroxyvitamin D ; Adolescent ; Adult ; Alfacalcidol ; Anemia ; Anemia, Iron-Deficiency - diagnosis ; Anemia, Iron-Deficiency - etiology ; Calcifediol ; Calcium (blood) ; Child ; Child, Preschool ; Children ; Chronic kidney failure ; Complications and side effects ; Cross-Sectional Studies ; Diseases ; Ferritin ; Ferritins ; Fibroblast growth factor 23 ; Fibroblast growth factor receptors ; Fibroblasts ; Fibroblasts - metabolism ; Health aspects ; Hemoglobin ; Hemoglobins - metabolism ; Humans ; Iron ; Iron Deficiencies ; Iron deficiency ; Kidney diseases ; Klotho protein ; Medicine ; Medicine & Public Health ; Minerals - metabolism ; Nephrology ; Nutrient deficiency ; Original Article ; Patients ; Pediatrics ; Renal Insufficiency, Chronic ; Urology ; Vitamin D ; Vitamin D Deficiency - complications ; Vitamin deficiency ; What’s New in Chronic Kidney Disease ; Young Adult</subject><ispartof>Pediatric nephrology (Berlin, West), 2023-08, Vol.38 (8), p.2771-2779</ispartof><rights>The Author(s), under exclusive licence to International Pediatric Nephrology Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association.</rights><rights>COPYRIGHT 2023 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-3c1557b3bcc4c2f071864635c9f37218d61709a10201c3ed5d6999aea3efba893</citedby><cites>FETCH-LOGICAL-c511t-3c1557b3bcc4c2f071864635c9f37218d61709a10201c3ed5d6999aea3efba893</cites><orcidid>0000-0003-3638-5179</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-023-05903-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-023-05903-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36862253$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karava, Vasiliki</creatorcontrib><creatorcontrib>Dotis, John</creatorcontrib><creatorcontrib>Kondou, Antonia</creatorcontrib><creatorcontrib>Christoforidis, Athanasios</creatorcontrib><creatorcontrib>Taparkou, Anna</creatorcontrib><creatorcontrib>Farmaki, Evangelia</creatorcontrib><creatorcontrib>Economou, Marina</creatorcontrib><creatorcontrib>Printza, Nikoleta</creatorcontrib><title>Fibroblast growth-factor 23 and vitamin D are associated with iron deficiency and anemia in children with chronic kidney disease</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background
This cross-sectional study investigates the association of fibroblast growth-factor 23 (FGF23) and other bone mineral parameters with iron status and anemia in pediatric chronic kidney disease (CKD).
Methods
Serum calcium, phosphorus, 25-hydroxyvitamin D (25(OH)D), intact parathormone, c-terminal FGF23, a-Klotho, iron (Fe), ferritin, unsaturated iron-binding capacity, and hemoglobin (Hb) were measured in 53 patients from 5 to 19 years old with GFR < 60 mL/min/1.73 m
2
. Transferrin saturation (TSAT) was calculated.
Results
Absolute (ferritin ≤ 100 ng/mL, TSAT ≤ 20%) and functional iron deficiency (ferritin > 100 ng/mL, TSAT ≤ 20%) were observed in 32% and 7.5% of patients, respectively. In CKD stages 3–4 (36 patients), lnFGF23 and 25(OH)D were correlated with Fe (rs = − 0.418,
p
= 0.012 and rs = 0.467,
p
= 0.005) and TSAT (rs = − 0.357,
p
= 0.035 and rs = 0.487,
p
= 0.003) but not to ferritin. In this patient group, lnFGF23 and 25(OH)D were correlated with Hb
z
-score (rs = − 0.649,
p
< 0.001 and rs = 0.358,
p
= 0.035). No correlation was detected between lnKlotho and iron parameters. In CKD stages 3–4, in multivariate backward logistic regression analysis, including bone mineral parameters, CKD stage, patient age, and daily alphacalcidol dose as covariates, lnFGF23 and 25(OH)D were associated with low TSΑΤ (15 patients) (OR 6.348, 95% CI 1.106–36.419, and OR 0.619, 95% CI 0.429–0.894, respectively); lnFGF23 was associated with low Hb (10 patients) (OR 5.747, 95% CI 1.270–26.005); while the association between 25(OH)D and low Hb did not reach statistical significance (OR 0.818, 95% CI 0.637–1.050).
Conclusions
In pediatric CKD stages 3–4, iron deficiency and anemia are associated with increased FGF23, independently of Klotho. Vitamin D deficiency might contribute to iron deficiency in this population.
Graphical abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information</description><subject>25-Hydroxyvitamin D</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Alfacalcidol</subject><subject>Anemia</subject><subject>Anemia, Iron-Deficiency - diagnosis</subject><subject>Anemia, Iron-Deficiency - etiology</subject><subject>Calcifediol</subject><subject>Calcium (blood)</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Chronic kidney failure</subject><subject>Complications and side effects</subject><subject>Cross-Sectional Studies</subject><subject>Diseases</subject><subject>Ferritin</subject><subject>Ferritins</subject><subject>Fibroblast growth factor 23</subject><subject>Fibroblast growth factor receptors</subject><subject>Fibroblasts</subject><subject>Fibroblasts - metabolism</subject><subject>Health aspects</subject><subject>Hemoglobin</subject><subject>Hemoglobins - metabolism</subject><subject>Humans</subject><subject>Iron</subject><subject>Iron Deficiencies</subject><subject>Iron deficiency</subject><subject>Kidney diseases</subject><subject>Klotho protein</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minerals - metabolism</subject><subject>Nephrology</subject><subject>Nutrient deficiency</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Renal Insufficiency, Chronic</subject><subject>Urology</subject><subject>Vitamin D</subject><subject>Vitamin D Deficiency - complications</subject><subject>Vitamin deficiency</subject><subject>What’s New in Chronic Kidney Disease</subject><subject>Young Adult</subject><issn>0931-041X</issn><issn>1432-198X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kk9rFTEUxQdR7LP6BVxIQBA3U_NnZpIsS7UqFNwodBcyyZ03qTNJTTItb-dHN-1Ua-UhWVzI_Z3D5XCq6iXBRwRj_i5h3HS8xpTVuJWY1exRtSENozWR4vxxtcGSkRo35PygepbSBcZYtKJ7Wh2wTnSUtmxT_Tx1fQz9pFNG2xiu81gP2uQQEWVIe4uuXNaz8-g90hGQTikYpzNYdO3yiFwMHlkYnHHgze5WoT3MTqOiMaObbAS_smYssDPou7Medsi6BDrB8-rJoKcEL-7mYfXt9MPXk0_12ZePn0-Oz2rTEpJrZkjb8p71xjSGDpgT0TUda40cGKdE2I5wLDXBFBPDwLa2k1Jq0AyGXgvJDqu3q-9lDD8WSFnNLhmYpnJuWJKiXJCOCEFxQV__g16EJfpynaKiaRpGWCvvqa2eQDk_hBy1uTFVx7zsGeeSF6reQ23BQ9RT8CW58v2AP9rDl2dLqGav4M1fghH0lMcUpiW74NNDkK6giSGlCIO6jG7WcacIVjd9UmufVOmTuu2TYkX06i6KpZ_B_pH8LlAB2AqksvJbiPdZ_cf2F97t0xk</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Karava, Vasiliki</creator><creator>Dotis, John</creator><creator>Kondou, Antonia</creator><creator>Christoforidis, Athanasios</creator><creator>Taparkou, Anna</creator><creator>Farmaki, Evangelia</creator><creator>Economou, Marina</creator><creator>Printza, Nikoleta</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3638-5179</orcidid></search><sort><creationdate>20230801</creationdate><title>Fibroblast growth-factor 23 and vitamin D are associated with iron deficiency and anemia in children with chronic kidney disease</title><author>Karava, Vasiliki ; Dotis, John ; Kondou, Antonia ; Christoforidis, Athanasios ; Taparkou, Anna ; Farmaki, Evangelia ; Economou, Marina ; Printza, Nikoleta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-3c1557b3bcc4c2f071864635c9f37218d61709a10201c3ed5d6999aea3efba893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>25-Hydroxyvitamin D</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Alfacalcidol</topic><topic>Anemia</topic><topic>Anemia, Iron-Deficiency - diagnosis</topic><topic>Anemia, Iron-Deficiency - etiology</topic><topic>Calcifediol</topic><topic>Calcium (blood)</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Chronic kidney failure</topic><topic>Complications and side effects</topic><topic>Cross-Sectional Studies</topic><topic>Diseases</topic><topic>Ferritin</topic><topic>Ferritins</topic><topic>Fibroblast growth factor 23</topic><topic>Fibroblast growth factor receptors</topic><topic>Fibroblasts</topic><topic>Fibroblasts - metabolism</topic><topic>Health aspects</topic><topic>Hemoglobin</topic><topic>Hemoglobins - metabolism</topic><topic>Humans</topic><topic>Iron</topic><topic>Iron Deficiencies</topic><topic>Iron deficiency</topic><topic>Kidney diseases</topic><topic>Klotho protein</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minerals - metabolism</topic><topic>Nephrology</topic><topic>Nutrient deficiency</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Renal Insufficiency, Chronic</topic><topic>Urology</topic><topic>Vitamin D</topic><topic>Vitamin D Deficiency - complications</topic><topic>Vitamin deficiency</topic><topic>What’s New in Chronic Kidney Disease</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karava, Vasiliki</creatorcontrib><creatorcontrib>Dotis, John</creatorcontrib><creatorcontrib>Kondou, Antonia</creatorcontrib><creatorcontrib>Christoforidis, Athanasios</creatorcontrib><creatorcontrib>Taparkou, Anna</creatorcontrib><creatorcontrib>Farmaki, Evangelia</creatorcontrib><creatorcontrib>Economou, Marina</creatorcontrib><creatorcontrib>Printza, Nikoleta</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karava, Vasiliki</au><au>Dotis, John</au><au>Kondou, Antonia</au><au>Christoforidis, Athanasios</au><au>Taparkou, Anna</au><au>Farmaki, Evangelia</au><au>Economou, Marina</au><au>Printza, Nikoleta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fibroblast growth-factor 23 and vitamin D are associated with iron deficiency and anemia in children with chronic kidney disease</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>38</volume><issue>8</issue><spage>2771</spage><epage>2779</epage><pages>2771-2779</pages><issn>0931-041X</issn><issn>1432-198X</issn><eissn>1432-198X</eissn><abstract>Background
This cross-sectional study investigates the association of fibroblast growth-factor 23 (FGF23) and other bone mineral parameters with iron status and anemia in pediatric chronic kidney disease (CKD).
Methods
Serum calcium, phosphorus, 25-hydroxyvitamin D (25(OH)D), intact parathormone, c-terminal FGF23, a-Klotho, iron (Fe), ferritin, unsaturated iron-binding capacity, and hemoglobin (Hb) were measured in 53 patients from 5 to 19 years old with GFR < 60 mL/min/1.73 m
2
. Transferrin saturation (TSAT) was calculated.
Results
Absolute (ferritin ≤ 100 ng/mL, TSAT ≤ 20%) and functional iron deficiency (ferritin > 100 ng/mL, TSAT ≤ 20%) were observed in 32% and 7.5% of patients, respectively. In CKD stages 3–4 (36 patients), lnFGF23 and 25(OH)D were correlated with Fe (rs = − 0.418,
p
= 0.012 and rs = 0.467,
p
= 0.005) and TSAT (rs = − 0.357,
p
= 0.035 and rs = 0.487,
p
= 0.003) but not to ferritin. In this patient group, lnFGF23 and 25(OH)D were correlated with Hb
z
-score (rs = − 0.649,
p
< 0.001 and rs = 0.358,
p
= 0.035). No correlation was detected between lnKlotho and iron parameters. In CKD stages 3–4, in multivariate backward logistic regression analysis, including bone mineral parameters, CKD stage, patient age, and daily alphacalcidol dose as covariates, lnFGF23 and 25(OH)D were associated with low TSΑΤ (15 patients) (OR 6.348, 95% CI 1.106–36.419, and OR 0.619, 95% CI 0.429–0.894, respectively); lnFGF23 was associated with low Hb (10 patients) (OR 5.747, 95% CI 1.270–26.005); while the association between 25(OH)D and low Hb did not reach statistical significance (OR 0.818, 95% CI 0.637–1.050).
Conclusions
In pediatric CKD stages 3–4, iron deficiency and anemia are associated with increased FGF23, independently of Klotho. Vitamin D deficiency might contribute to iron deficiency in this population.
Graphical abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36862253</pmid><doi>10.1007/s00467-023-05903-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3638-5179</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-041X |
| ispartof | Pediatric nephrology (Berlin, West), 2023-08, Vol.38 (8), p.2771-2779 |
| issn | 0931-041X 1432-198X 1432-198X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2781618820 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | 25-Hydroxyvitamin D Adolescent Adult Alfacalcidol Anemia Anemia, Iron-Deficiency - diagnosis Anemia, Iron-Deficiency - etiology Calcifediol Calcium (blood) Child Child, Preschool Children Chronic kidney failure Complications and side effects Cross-Sectional Studies Diseases Ferritin Ferritins Fibroblast growth factor 23 Fibroblast growth factor receptors Fibroblasts Fibroblasts - metabolism Health aspects Hemoglobin Hemoglobins - metabolism Humans Iron Iron Deficiencies Iron deficiency Kidney diseases Klotho protein Medicine Medicine & Public Health Minerals - metabolism Nephrology Nutrient deficiency Original Article Patients Pediatrics Renal Insufficiency, Chronic Urology Vitamin D Vitamin D Deficiency - complications Vitamin deficiency What’s New in Chronic Kidney Disease Young Adult |
| title | Fibroblast growth-factor 23 and vitamin D are associated with iron deficiency and anemia in children with chronic kidney disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T07%3A31%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Fibroblast%20growth-factor%2023%20and%20vitamin%20D%20are%20associated%20with%20iron%20deficiency%20and%20anemia%20in%20children%20with%20chronic%20kidney%20disease&rft.jtitle=Pediatric%20nephrology%20(Berlin,%20West)&rft.au=Karava,%20Vasiliki&rft.date=2023-08-01&rft.volume=38&rft.issue=8&rft.spage=2771&rft.epage=2779&rft.pages=2771-2779&rft.issn=0931-041X&rft.eissn=1432-198X&rft_id=info:doi/10.1007/s00467-023-05903-3&rft_dat=%3Cgale_proqu%3EA759337797%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2844431359&rft_id=info:pmid/36862253&rft_galeid=A759337797&rfr_iscdi=true |