Prognostic value and link to atrial fibrillation of soluble Klotho and FGF23 in hemodialysis patients
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Prognostic value and link to atrial fibrillation of soluble Klotho and FGF23 in hemodialysis patients. / Nowak, Albina; Friedrich, Björn; Artunc, Ferruh; Serra, Andreas L; Breidthardt, Tobias; Twerenbold, Raphael; Peter, Myriam; Mueller, Christian.
in: PLOS ONE, Jahrgang 9, Nr. 7, 2014, S. e100688.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Prognostic value and link to atrial fibrillation of soluble Klotho and FGF23 in hemodialysis patients
AU - Nowak, Albina
AU - Friedrich, Björn
AU - Artunc, Ferruh
AU - Serra, Andreas L
AU - Breidthardt, Tobias
AU - Twerenbold, Raphael
AU - Peter, Myriam
AU - Mueller, Christian
PY - 2014
Y1 - 2014
N2 - Deranged calcium-phosphate metabolism contributes to the burden of morbidity and mortality in dialysis patients. This study aimed to assess the association of the phosphaturic hormone fibroblast growth factor 23 (FGF23) and soluble Klotho with all-cause mortality. We measured soluble Klotho and FGF23 levels at enrolment and two weeks later in 239 prevalent hemodialysis patients. The primary hypothesis was that low Klotho and high FGF23 are associated with increased mortality. The association between Klotho and atrial fibrillation (AF) at baseline was explored as secondary outcome. AF was defined as presence of paroxysmal, persistent or permanent AF. During a median follow-up of 924 days, 59 (25%) patients died from any cause. Lower Klotho levels were not associated with mortality in a multivariable adjusted analysis when examined either on a continuous scale (HR 1.25 per SD increase, 95% CI 0.84-1.86) or in tertiles, with tertile 1 as the reference category (HR for tertile two 0.65, 95% CI 0.26-1.64; HR for tertile three 2.18, 95% CI 0.91-2.23). Higher Klotho levels were associated with the absence of AF in a muItivariable logistic regression analysis (OR 0.66 per SD increase, 95% CI 0.41-1.00). Higher FGF23 levels were associated with mortality risk in a multivariable adjusted analysis when examined either on a continuous scale (HR 1.45 per SD increase, 95% CI 1.05-1.99) or in tertiles, with the tertile 1 as the reference category (HR for tertile two 1.63, 95% CI 0.64-4.14; HR for tertile three 3.91, 95% CI 1.28-12.20). FGF23 but not Klotho levels are associated with mortality in hemodialysis patients. Klotho may be protective against AF.
AB - Deranged calcium-phosphate metabolism contributes to the burden of morbidity and mortality in dialysis patients. This study aimed to assess the association of the phosphaturic hormone fibroblast growth factor 23 (FGF23) and soluble Klotho with all-cause mortality. We measured soluble Klotho and FGF23 levels at enrolment and two weeks later in 239 prevalent hemodialysis patients. The primary hypothesis was that low Klotho and high FGF23 are associated with increased mortality. The association between Klotho and atrial fibrillation (AF) at baseline was explored as secondary outcome. AF was defined as presence of paroxysmal, persistent or permanent AF. During a median follow-up of 924 days, 59 (25%) patients died from any cause. Lower Klotho levels were not associated with mortality in a multivariable adjusted analysis when examined either on a continuous scale (HR 1.25 per SD increase, 95% CI 0.84-1.86) or in tertiles, with tertile 1 as the reference category (HR for tertile two 0.65, 95% CI 0.26-1.64; HR for tertile three 2.18, 95% CI 0.91-2.23). Higher Klotho levels were associated with the absence of AF in a muItivariable logistic regression analysis (OR 0.66 per SD increase, 95% CI 0.41-1.00). Higher FGF23 levels were associated with mortality risk in a multivariable adjusted analysis when examined either on a continuous scale (HR 1.45 per SD increase, 95% CI 1.05-1.99) or in tertiles, with the tertile 1 as the reference category (HR for tertile two 1.63, 95% CI 0.64-4.14; HR for tertile three 3.91, 95% CI 1.28-12.20). FGF23 but not Klotho levels are associated with mortality in hemodialysis patients. Klotho may be protective against AF.
KW - Aged
KW - Aged, 80 and over
KW - Atrial Fibrillation/blood
KW - Disease-Free Survival
KW - Female
KW - Fibroblast Growth Factor-23
KW - Fibroblast Growth Factors/blood
KW - Glucuronidase/blood
KW - Humans
KW - Klotho Proteins
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Renal Dialysis
KW - Survival Rate
U2 - 10.1371/journal.pone.0100688
DO - 10.1371/journal.pone.0100688
M3 - SCORING: Journal article
C2 - 24991914
VL - 9
SP - e100688
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 7
ER -