Fibroblast Growth Factor 23 in Hemodialysis Patients: Effects of Phosphate Binder, Calcitriol and Calcium Concentration in the Dialysate

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dc.contributor.authorCancela, Ana L. E.
dc.contributor.authorOliveira, Rodrigo B.
dc.contributor.authorGraciolli, Fabiana G.
dc.contributor.authorReis, Luciene M. dos
dc.contributor.authorBarreto, Fellype [UNIFESP]
dc.contributor.authorBarreto, Daniela V. [UNIFESP]
dc.contributor.authorCuppari, Lilian [UNIFESP]
dc.contributor.authorJorgetti, Vanda
dc.contributor.authorCarvalho, Aluizio B. [UNIFESP]
dc.contributor.authorCanziani, Maria Eugenia [UNIFESP]
dc.contributor.authorMoyses, Rosa M. A.
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:06:01Z
dc.date.available2016-01-24T14:06:01Z
dc.date.issued2011-01-01
dc.description.abstractBackground: Fibroblast growth factor 23 (FGF23) concentrations increase early in chronic kidney disease (CKD), and the influence of current CKD-mineral and bone disorder (MBD) therapies on serum FGF23 levels is still under investigation. Methods: in this post-hoc analysis of a randomized clinical trial, phosphate binders and calcitriol were washed out of 72 hemodialysis patients who were then submitted to bone biopsy, coronary tomography and biochemical measures, including FGF23. They were randomized to receive sevelamer or calcium acetate for 1 year and the prescription of calcitriol and the calcium concentration in the dialysate were adjusted according to serum calcium, phosphate and PTH and bone biopsy diagnosis. Results: At baseline, bone biopsy showed that 58.3% had low-turnover bone disease, whereas 38.9% had high-turnover bone disease, with no significant differences between them with regard to FGF23. Median baseline FGF23 serum levels were elevated and correlated positively with serum phosphate. After 1 year, serum FGF23 decreased significantly. Repeated measures ANOVA analysis showed that the use of a 3.5-mEq/l calcium concentration in the dialysate, as well as the administration of calcitriol and a calcium-based phosphate binder were associated with higher final serum FGF23 levels. Conclusions: Taken together, our results confirm that the current CKD-MBD therapies have an effect on serum levels of FGF23. Since FGF23 is emerging as a potential treatment target, our findings should be taken into account in the decision on how to manage CKD-MBD therapy. Copyright (C) 2010 S. Karger AG, Baselen
dc.description.affiliationUniv São Paulo, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, EPM, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipGenzyme
dc.format.extentC74-C82
dc.identifierhttp://dx.doi.org/10.1159/000319650
dc.identifier.citationNephron Clinical Practice. Basel: Karger, v. 117, n. 1, p. C74-C82, 2011.
dc.identifier.doi10.1159/000319650
dc.identifier.issn1660-2110
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/33326
dc.identifier.wosWOS:000280683300013
dc.language.isoeng
dc.publisherKarger
dc.relation.ispartofNephron Clinical Practice
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.karger.com/Services/RightsPermissions
dc.subjectFibroblast growth factor 23en
dc.subjectCalcitriolen
dc.subjectPhosphateen
dc.subjectCalciumen
dc.subjectSevelameren
dc.subjectBone biopsyen
dc.subjectCoronary calcificationen
dc.subjectDialysateen
dc.titleFibroblast Growth Factor 23 in Hemodialysis Patients: Effects of Phosphate Binder, Calcitriol and Calcium Concentration in the Dialysateen
dc.typeinfo:eu-repo/semantics/article
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