FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study
Background Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was t...
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| Veröffentlicht in: | Annals of intensive care 2011-06, Vol.1 (1), p.21-21, Article 21 |
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| creator | Zhang, MaryAnn Hsu, Raymond Hsu, Chi-yuan Kordesch, Kristina Nicasio, Erica Cortez, Alfredo McAlpine, Ian Brady, Sandra Zhuo, Hanjing Kangelaris, Kirsten N Stein, John Calfee, Carolyn S Liu, Kathleen D |
| description | Background
Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was to measure FGF-23 levels in critically ill patients with acute kidney injury to determine whether FGF-23 levels were elevated, as in chronic kidney disease.
Methods
Plasma FGF-23 and intact parathyroid hormone (PTH) levels were measured in 12 patients with acute kidney injury and 8 control subjects.
Results
FGF-23 levels were significantly higher in acute kidney injury cases than in critically ill subjects without acute kidney injury, with a median FGF-23 level of 1948 RU/mL (interquartile range (IQR), 437-4369) in cases compared with 252 RU/mL (IQR, 65-533) in controls (
p
= 0.01). No correlations were observed between FGF-23 and severity of acute kidney injury (defined by the Acute Kidney Injury Network criteria); among patients with acute kidney injury, FGF-23 levels were higher in nonsurvivors than survivors (median levels of 4446 RU/mL (IQR, 3455-5443) versus 544 RU/mL (IQR, 390-1948;
p
= 0.02). Severe hyperparathyroidism (defined as intact PTH >250 mg/dL) was present in 3 of 12 (25%) of the acute kidney injury subjects versus none of the subjects without acute kidney injury, although this result did not meet statistical significance.
Conclusions
We provide novel data that demonstrate that FGF-23 levels are elevated in acute kidney injury, suggesting that FGF-23 dysregulation occurs in acute kidney injury as well as chronic kidney disease. Further studies are needed to define the short- and long-term clinical effects of dysregulated mineral metabolism in acute kidney injury patients. |
| doi_str_mv | 10.1186/2110-5820-1-21 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3224491</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3584957071</sourcerecordid><originalsourceid>FETCH-LOGICAL-b445t-465f0af619ceaac8505cd280bbee4ddfdef42b085f05fa450dfdaddceb0807e83</originalsourceid><addsrcrecordid>eNp1ks9PHCEUx0lTU4167bEh6aGnUWBgfvRgsjGumpjowZ4JA2-U7SxsgdHsfy_r6matyoWX9_3k-16-gNB3So4obapjRikpRMNIQQtGv6C9TePrVr2LDmOckXwEqRkrv6FdRltSlVW5h-T0fFqwEitn8M3tBR7gAYaIrcMLlSy4FPGjTfdY6TEB_muNg2VWZ2NY_sYTrIOPsYigk_VODVirCDhCsBBxTKNZHqCdXg0RDl_uffRnenZ7elFcXZ9fnk6uio5zkQpeiZ6ovqKtBqV0I4jQhjWk6wC4Mb2BnrOONJkSveKC5JYyRkPukRqach-drH0XYzeHLLgU1CAXwc5VWEqvrHyrOHsv7_yDLBnjvKXZYLI26Kz_xOCtov1crjKWq4wlzXX2-PWyRPD_RohJzm3UMAzKgR-jbJqW1oJRnsmf_5EzP4acYJS0EqyqW0HrTB2tqeeYA_SbdfLY1Q94v8CP7RQ2-Ot7Z-B4DcQsuTsIW3M_tnwC-vG7vw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1652679517</pqid></control><display><type>article</type><title>FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study</title><source>PMC (PubMed Central)</source><source>DOAJ Directory of Open Access Journals</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><creator>Zhang, MaryAnn ; Hsu, Raymond ; Hsu, Chi-yuan ; Kordesch, Kristina ; Nicasio, Erica ; Cortez, Alfredo ; McAlpine, Ian ; Brady, Sandra ; Zhuo, Hanjing ; Kangelaris, Kirsten N ; Stein, John ; Calfee, Carolyn S ; Liu, Kathleen D</creator><creatorcontrib>Zhang, MaryAnn ; Hsu, Raymond ; Hsu, Chi-yuan ; Kordesch, Kristina ; Nicasio, Erica ; Cortez, Alfredo ; McAlpine, Ian ; Brady, Sandra ; Zhuo, Hanjing ; Kangelaris, Kirsten N ; Stein, John ; Calfee, Carolyn S ; Liu, Kathleen D</creatorcontrib><description>Background
Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was to measure FGF-23 levels in critically ill patients with acute kidney injury to determine whether FGF-23 levels were elevated, as in chronic kidney disease.
Methods
Plasma FGF-23 and intact parathyroid hormone (PTH) levels were measured in 12 patients with acute kidney injury and 8 control subjects.
Results
FGF-23 levels were significantly higher in acute kidney injury cases than in critically ill subjects without acute kidney injury, with a median FGF-23 level of 1948 RU/mL (interquartile range (IQR), 437-4369) in cases compared with 252 RU/mL (IQR, 65-533) in controls (
p
= 0.01). No correlations were observed between FGF-23 and severity of acute kidney injury (defined by the Acute Kidney Injury Network criteria); among patients with acute kidney injury, FGF-23 levels were higher in nonsurvivors than survivors (median levels of 4446 RU/mL (IQR, 3455-5443) versus 544 RU/mL (IQR, 390-1948;
p
= 0.02). Severe hyperparathyroidism (defined as intact PTH >250 mg/dL) was present in 3 of 12 (25%) of the acute kidney injury subjects versus none of the subjects without acute kidney injury, although this result did not meet statistical significance.
Conclusions
We provide novel data that demonstrate that FGF-23 levels are elevated in acute kidney injury, suggesting that FGF-23 dysregulation occurs in acute kidney injury as well as chronic kidney disease. Further studies are needed to define the short- and long-term clinical effects of dysregulated mineral metabolism in acute kidney injury patients.</description><identifier>ISSN: 2110-5820</identifier><identifier>EISSN: 2110-5820</identifier><identifier>DOI: 10.1186/2110-5820-1-21</identifier><identifier>PMID: 21906363</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Anesthesiology ; Critical Care Medicine ; Emergency Medicine ; Intensive ; Intensive care ; Medicine ; Medicine & Public Health</subject><ispartof>Annals of intensive care, 2011-06, Vol.1 (1), p.21-21, Article 21</ispartof><rights>Zhang et al; licensee Springer. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Société de réanimation de langue française (SRLF) and Springer-Verlag France 2011</rights><rights>Copyright ©2011 Zhang et al; licensee Springer. 2011 Zhang et al; licensee Springer.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b445t-465f0af619ceaac8505cd280bbee4ddfdef42b085f05fa450dfdaddceb0807e83</citedby><cites>FETCH-LOGICAL-b445t-465f0af619ceaac8505cd280bbee4ddfdef42b085f05fa450dfdaddceb0807e83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224491/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224491/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21906363$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, MaryAnn</creatorcontrib><creatorcontrib>Hsu, Raymond</creatorcontrib><creatorcontrib>Hsu, Chi-yuan</creatorcontrib><creatorcontrib>Kordesch, Kristina</creatorcontrib><creatorcontrib>Nicasio, Erica</creatorcontrib><creatorcontrib>Cortez, Alfredo</creatorcontrib><creatorcontrib>McAlpine, Ian</creatorcontrib><creatorcontrib>Brady, Sandra</creatorcontrib><creatorcontrib>Zhuo, Hanjing</creatorcontrib><creatorcontrib>Kangelaris, Kirsten N</creatorcontrib><creatorcontrib>Stein, John</creatorcontrib><creatorcontrib>Calfee, Carolyn S</creatorcontrib><creatorcontrib>Liu, Kathleen D</creatorcontrib><title>FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study</title><title>Annals of intensive care</title><addtitle>Ann. Intensive Care</addtitle><addtitle>Ann Intensive Care</addtitle><description>Background
Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was to measure FGF-23 levels in critically ill patients with acute kidney injury to determine whether FGF-23 levels were elevated, as in chronic kidney disease.
Methods
Plasma FGF-23 and intact parathyroid hormone (PTH) levels were measured in 12 patients with acute kidney injury and 8 control subjects.
Results
FGF-23 levels were significantly higher in acute kidney injury cases than in critically ill subjects without acute kidney injury, with a median FGF-23 level of 1948 RU/mL (interquartile range (IQR), 437-4369) in cases compared with 252 RU/mL (IQR, 65-533) in controls (
p
= 0.01). No correlations were observed between FGF-23 and severity of acute kidney injury (defined by the Acute Kidney Injury Network criteria); among patients with acute kidney injury, FGF-23 levels were higher in nonsurvivors than survivors (median levels of 4446 RU/mL (IQR, 3455-5443) versus 544 RU/mL (IQR, 390-1948;
p
= 0.02). Severe hyperparathyroidism (defined as intact PTH >250 mg/dL) was present in 3 of 12 (25%) of the acute kidney injury subjects versus none of the subjects without acute kidney injury, although this result did not meet statistical significance.
Conclusions
We provide novel data that demonstrate that FGF-23 levels are elevated in acute kidney injury, suggesting that FGF-23 dysregulation occurs in acute kidney injury as well as chronic kidney disease. Further studies are needed to define the short- and long-term clinical effects of dysregulated mineral metabolism in acute kidney injury patients.</description><subject>Anesthesiology</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><issn>2110-5820</issn><issn>2110-5820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>BENPR</sourceid><recordid>eNp1ks9PHCEUx0lTU4167bEh6aGnUWBgfvRgsjGumpjowZ4JA2-U7SxsgdHsfy_r6matyoWX9_3k-16-gNB3So4obapjRikpRMNIQQtGv6C9TePrVr2LDmOckXwEqRkrv6FdRltSlVW5h-T0fFqwEitn8M3tBR7gAYaIrcMLlSy4FPGjTfdY6TEB_muNg2VWZ2NY_sYTrIOPsYigk_VODVirCDhCsBBxTKNZHqCdXg0RDl_uffRnenZ7elFcXZ9fnk6uio5zkQpeiZ6ovqKtBqV0I4jQhjWk6wC4Mb2BnrOONJkSveKC5JYyRkPukRqach-drH0XYzeHLLgU1CAXwc5VWEqvrHyrOHsv7_yDLBnjvKXZYLI26Kz_xOCtov1crjKWq4wlzXX2-PWyRPD_RohJzm3UMAzKgR-jbJqW1oJRnsmf_5EzP4acYJS0EqyqW0HrTB2tqeeYA_SbdfLY1Q94v8CP7RQ2-Ot7Z-B4DcQsuTsIW3M_tnwC-vG7vw</recordid><startdate>20110614</startdate><enddate>20110614</enddate><creator>Zhang, MaryAnn</creator><creator>Hsu, Raymond</creator><creator>Hsu, Chi-yuan</creator><creator>Kordesch, Kristina</creator><creator>Nicasio, Erica</creator><creator>Cortez, Alfredo</creator><creator>McAlpine, Ian</creator><creator>Brady, Sandra</creator><creator>Zhuo, Hanjing</creator><creator>Kangelaris, Kirsten N</creator><creator>Stein, John</creator><creator>Calfee, Carolyn S</creator><creator>Liu, Kathleen D</creator><general>Springer Paris</general><general>Springer Nature B.V</general><general>BioMed Central Ltd</general><general>Springer</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20110614</creationdate><title>FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study</title><author>Zhang, MaryAnn ; Hsu, Raymond ; Hsu, Chi-yuan ; Kordesch, Kristina ; Nicasio, Erica ; Cortez, Alfredo ; McAlpine, Ian ; Brady, Sandra ; Zhuo, Hanjing ; Kangelaris, Kirsten N ; Stein, John ; Calfee, Carolyn S ; Liu, Kathleen D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b445t-465f0af619ceaac8505cd280bbee4ddfdef42b085f05fa450dfdaddceb0807e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Anesthesiology</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, MaryAnn</creatorcontrib><creatorcontrib>Hsu, Raymond</creatorcontrib><creatorcontrib>Hsu, Chi-yuan</creatorcontrib><creatorcontrib>Kordesch, Kristina</creatorcontrib><creatorcontrib>Nicasio, Erica</creatorcontrib><creatorcontrib>Cortez, Alfredo</creatorcontrib><creatorcontrib>McAlpine, Ian</creatorcontrib><creatorcontrib>Brady, Sandra</creatorcontrib><creatorcontrib>Zhuo, Hanjing</creatorcontrib><creatorcontrib>Kangelaris, Kirsten N</creatorcontrib><creatorcontrib>Stein, John</creatorcontrib><creatorcontrib>Calfee, Carolyn S</creatorcontrib><creatorcontrib>Liu, Kathleen D</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</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>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of intensive care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, MaryAnn</au><au>Hsu, Raymond</au><au>Hsu, Chi-yuan</au><au>Kordesch, Kristina</au><au>Nicasio, Erica</au><au>Cortez, Alfredo</au><au>McAlpine, Ian</au><au>Brady, Sandra</au><au>Zhuo, Hanjing</au><au>Kangelaris, Kirsten N</au><au>Stein, John</au><au>Calfee, Carolyn S</au><au>Liu, Kathleen D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study</atitle><jtitle>Annals of intensive care</jtitle><stitle>Ann. Intensive Care</stitle><addtitle>Ann Intensive Care</addtitle><date>2011-06-14</date><risdate>2011</risdate><volume>1</volume><issue>1</issue><spage>21</spage><epage>21</epage><pages>21-21</pages><artnum>21</artnum><issn>2110-5820</issn><eissn>2110-5820</eissn><abstract>Background
Fibroblast growth factor-23 (FGF-23), a novel regulator of mineral metabolism, is markedly elevated in chronic kidney disease and has been associated with poor long-term outcomes. However, whether FGF-23 has an analogous role in acute kidney injury is unknown. The goal of this study was to measure FGF-23 levels in critically ill patients with acute kidney injury to determine whether FGF-23 levels were elevated, as in chronic kidney disease.
Methods
Plasma FGF-23 and intact parathyroid hormone (PTH) levels were measured in 12 patients with acute kidney injury and 8 control subjects.
Results
FGF-23 levels were significantly higher in acute kidney injury cases than in critically ill subjects without acute kidney injury, with a median FGF-23 level of 1948 RU/mL (interquartile range (IQR), 437-4369) in cases compared with 252 RU/mL (IQR, 65-533) in controls (
p
= 0.01). No correlations were observed between FGF-23 and severity of acute kidney injury (defined by the Acute Kidney Injury Network criteria); among patients with acute kidney injury, FGF-23 levels were higher in nonsurvivors than survivors (median levels of 4446 RU/mL (IQR, 3455-5443) versus 544 RU/mL (IQR, 390-1948;
p
= 0.02). Severe hyperparathyroidism (defined as intact PTH >250 mg/dL) was present in 3 of 12 (25%) of the acute kidney injury subjects versus none of the subjects without acute kidney injury, although this result did not meet statistical significance.
Conclusions
We provide novel data that demonstrate that FGF-23 levels are elevated in acute kidney injury, suggesting that FGF-23 dysregulation occurs in acute kidney injury as well as chronic kidney disease. Further studies are needed to define the short- and long-term clinical effects of dysregulated mineral metabolism in acute kidney injury patients.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>21906363</pmid><doi>10.1186/2110-5820-1-21</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Annals of intensive care, 2011-06, Vol.1 (1), p.21-21, Article 21 |
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| language | eng |
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| source | PMC (PubMed Central); DOAJ Directory of Open Access Journals; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access |
| subjects | Anesthesiology Critical Care Medicine Emergency Medicine Intensive Intensive care Medicine Medicine & Public Health |
| title | FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study |
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