Teppei Sakoh1, Masaru Nakayama2, Takuya Tsuchihashi3, Ryota Yoshitomi4, Shigeru Tanaka5, Eisuke Katafuchi6, Akiko Fukui7, Yui Shikuwa8, Naohiko Anzai9, Takanari Kitazono10, Kazuhiko Tsuruya11. 1. Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Electronic address: tsakoh42@kyumed.jp. 2. Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan. Electronic address: mnaka@kyumed.jp. 3. Division of Hypertension, Department of Internal Medicine, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, Fukuoka 805-8508, Japan. Electronic address: tuti@ns.yawata-mhp.or.jp. 4. Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Electronic address: ryoshitomi.1130@gmail.com. 5. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Internal Medicine, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan. Electronic address: sigella1975@gmail.com. 6. Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan. Electronic address: kesuiechifutaka@kyumed.jp. 7. Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan. Electronic address: akiko-march1119@hotmail.co.jp. 8. Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan. Electronic address: shiku.yui@gmail.com. 9. Department of Pharmacology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. Electronic address: anzai@chiba-u.jp. 10. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Electronic address: kitazono@intmed2.med.kyushu-u.ac.jp. 11. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Electronic address: tsuruya@intmed2.med.kyushu-u.ac.jp.
Abstract
OBJECTIVE: In patients with preserved kidney function, a positive association of fibroblast growth factor 23 (FGF23) with serum uric acid (SUA) has been reported; however, the relationship in overall chronic kidney disease (CKD) patients has not been investigated. No report has examined the relationship between FGF23 and uric acid clearance (CUA). The aim of the present study was to determine whether FGF23 is independently associated with urate metabolism in patients with CKD stages 1-5. MATERIALS AND METHODS: In this cross-sectional study, 537 CKD patients were enrolled. SUA, CUA, FGF23, parathyroid hormone (PTH), and 1,25-dihydroxyvitamin D (1,25(OH)2D) were measured. Multivariable linear regression analysis was applied to determine independent factors associated with SUA or CUA. RESULTS: In all patients, both SUA and CUA were independently associated with male sex, use of diuretics, use of uric acid-lowering agents, estimated glomerular filtration rate, and log FGF23 (β=0.29, P<0.01 for SUA; β=-0.11, P<0.01 for CUA), but not with log PTH or log 1,25(OH)2D. Dyslipidemia and diabetes were also independent factors for SUA and CUA, respectively. In multivariable analyses by sex, log FGF23 was associated with SUA in both sexes (β=0.32, P<0.01 in males vs. β=0.20, P=0.02 in females). Conversely, log FGF23 was independently associated with CUA in males (β=-0.15, P<0.01), but not in females (β=-0.09, P=0.17). CONCLUSIONS: FGF23 was independently associated with urate metabolism in this population of CKD patients. FGF23 might also have a stronger association with urate metabolism in males compared with females.
OBJECTIVE: In patients with preserved kidney function, a positive association of fibroblast growth factor 23 (FGF23) with serum uric acid (SUA) has been reported; however, the relationship in overall chronic kidney disease (CKD) patients has not been investigated. No report has examined the relationship between FGF23 and uric acid clearance (CUA). The aim of the present study was to determine whether FGF23 is independently associated with urate metabolism in patients with CKD stages 1-5. MATERIALS AND METHODS: In this cross-sectional study, 537 CKDpatients were enrolled. SUA, CUA, FGF23, parathyroid hormone (PTH), and 1,25-dihydroxyvitamin D (1,25(OH)2D) were measured. Multivariable linear regression analysis was applied to determine independent factors associated with SUA or CUA. RESULTS: In all patients, both SUA and CUA were independently associated with male sex, use of diuretics, use of uric acid-lowering agents, estimated glomerular filtration rate, and log FGF23 (β=0.29, P<0.01 for SUA; β=-0.11, P<0.01 for CUA), but not with log PTH or log 1,25(OH)2D. Dyslipidemia and diabetes were also independent factors for SUA and CUA, respectively. In multivariable analyses by sex, log FGF23 was associated with SUA in both sexes (β=0.32, P<0.01 in males vs. β=0.20, P=0.02 in females). Conversely, log FGF23 was independently associated with CUA in males (β=-0.15, P<0.01), but not in females (β=-0.09, P=0.17). CONCLUSIONS:FGF23 was independently associated with urate metabolism in this population of CKDpatients. FGF23 might also have a stronger association with urate metabolism in males compared with females.
Authors: Baris Afsar; Alan A Sag; Cinar Oztosun; Masanari Kuwabara; Mario Cozzolino; Adrian Covic; Mehmet Kanbay Journal: J Nephrol Date: 2019-04-27 Impact factor: 3.902
Authors: Emily S Andrews; Loni Perrenoud; Kristen L Nowak; Zhiying You; Andreas Pasch; Michel Chonchol; Jessica Kendrick; Diana Jalal Journal: PLoS One Date: 2018-10-24 Impact factor: 3.240