CONTEXT: Fibroblast growth factor (FGF)-23 is produced in bone, and circulating levels are markedly elevated in patients with end-stage kidney disease, but the relationship between plasma levels of FGF-23 and bone histology in dialysis patients with secondary hyperparathyroidism is unknown. OBJECTIVE: The aim of the study was to evaluate the correlation between plasma levels of FGF-23 and bone histology in pediatric patients with end-stage kidney disease who display biochemical evidence of secondary hyperparathyroidism. DESIGN: We performed a cross-sectional analysis of the relationship between plasma FGF-23 levels and bone histomorphometry. SETTING: The study was conducted in a referral center. STUDY PARTICIPANTS: Participants consisted of forty-nine pediatric patients who were treated with maintenance peritoneal dialysis and who had serum PTH levels (1st generation Nichols assay) greater than 400 pg/ml. INTERVENTION: There were no interventions. MAIN OUTCOME MEASURE: Plasma FGF-23 levels and bone histomorphometry were measured. RESULTS: No correlation existed between values of PTH and FGF-23. Bone formation rates correlated with PTH (r = 0.44; P < 0.01), but not with FGF-23. Higher FGF-23 concentrations were associated with decreased osteoid thickness (r = -0.49; P < 0.01) and shorter osteoid maturation time (r = -0.48; P < 0.01). CONCLUSIONS: High levels of FGF-23 are associated with improved indices of skeletal mineralization in dialyzed pediatric patients with high turnover renal osteodystrophy. Together with other biomarkers, FGF-23 measurements may indicate skeletal mineralization status in this patient population.
CONTEXT: Fibroblast growth factor (FGF)-23 is produced in bone, and circulating levels are markedly elevated in patients with end-stage kidney disease, but the relationship between plasma levels of FGF-23 and bone histology in dialysis patients with secondary hyperparathyroidism is unknown. OBJECTIVE: The aim of the study was to evaluate the correlation between plasma levels of FGF-23 and bone histology in pediatric patients with end-stage kidney disease who display biochemical evidence of secondary hyperparathyroidism. DESIGN: We performed a cross-sectional analysis of the relationship between plasma FGF-23 levels and bone histomorphometry. SETTING: The study was conducted in a referral center. STUDY PARTICIPANTS: Participants consisted of forty-nine pediatric patients who were treated with maintenance peritoneal dialysis and who had serum PTH levels (1st generation Nichols assay) greater than 400 pg/ml. INTERVENTION: There were no interventions. MAIN OUTCOME MEASURE: Plasma FGF-23 levels and bone histomorphometry were measured. RESULTS: No correlation existed between values of PTH and FGF-23. Bone formation rates correlated with PTH (r = 0.44; P < 0.01), but not with FGF-23. Higher FGF-23 concentrations were associated with decreased osteoid thickness (r = -0.49; P < 0.01) and shorter osteoid maturation time (r = -0.48; P < 0.01). CONCLUSIONS: High levels of FGF-23 are associated with improved indices of skeletal mineralization in dialyzed pediatric patients with high turnover renal osteodystrophy. Together with other biomarkers, FGF-23 measurements may indicate skeletal mineralization status in this patient population.
Authors: Jaap W Groothoff; Martin Offringa; Berthe L F Van Eck-Smit; Mariken P Gruppen; Nicole J Van De Kar; Eric D Wolff; Marc R Lilien; Jean Claude Davin; Hugo S A Heymans; Friedo W Dekker Journal: Kidney Int Date: 2003-01 Impact factor: 10.612
Authors: Isidro B Salusky; William G Goodman; Beatriz D Kuizon; Jeffrey R Lavigne; Richard J Zahranik; Barbara Gales; He-Jing Wang; Robert M Elashoff; Harald Jüppner Journal: Kidney Int Date: 2003-05 Impact factor: 10.612
Authors: T Shimada; S Mizutani; T Muto; T Yoneya; R Hino; S Takeda; Y Takeuchi; T Fujita; S Fukumoto; T Yamashita Journal: Proc Natl Acad Sci U S A Date: 2001-05-08 Impact factor: 11.205
Authors: P S N Rowe; Y Kumagai; G Gutierrez; I R Garrett; R Blacher; D Rosen; J Cundy; S Navvab; D Chen; M K Drezner; L D Quarles; G R Mundy Journal: Bone Date: 2004-02 Impact factor: 4.398