Fibroblast growth factor 23 and calcium phosphate homeostasis after pediatric renal transplantation.
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Fibroblast growth factor 23 and calcium phosphate homeostasis after pediatric renal transplantation. / Van Husen, Michel; Lehnhardt, Anja; Fischer, Ann-Katrin; Brinkert, Florian; Loos, Sebastian; Oh, Jun; Kemper, Markus J.
In: PEDIATR TRANSPLANT, Vol. 16, No. 5, 5, 2012, p. 443-450.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Fibroblast growth factor 23 and calcium phosphate homeostasis after pediatric renal transplantation.
AU - Van Husen, Michel
AU - Lehnhardt, Anja
AU - Fischer, Ann-Katrin
AU - Brinkert, Florian
AU - Loos, Sebastian
AU - Oh, Jun
AU - Kemper, Markus J.
PY - 2012
Y1 - 2012
N2 - FGF23 is a circulating factor regulating TPR and is increased in CKD. After RT, it seems to induce phosphorus wasting in adults. Data on FGF23 after PRT are scarce. Parameters of bone metabolism including calcium, phosphate, 25-(OH) vitamin D, 1,25-(OH)(2) vitamin D, alkaline phosphatase, PTH, and FGF23 were analyzed in 57 children after PRT and 11 controls. Median time after PRT was 25.9 (range 2-135) months. eGFR after PRT ranged from 15 to 175 mL/min/1.73 qm. Mean (±s.e.) FGF23 and PTH levels were significantly elevated compared with controls (146 ± 30 vs. 43 ± 3 ng/L, p = 0.001 and 182 ± 42 vs. 74 ± 18 ng/L, p = 0.004, respectively). Highest FGF23 levels were found in children with an eGFR below 60 mL/min*1.73 sqm (280 ± 69 vs. 62 ± 5 ng/L, p = 0.001), but significantly elevated values were already present in CKD2T. In a multivariate analysis, eGFR, PTH, calcium, and phosphate were significantly associated with FGF23. In a subgroup of 17 patients (29.8%) with persistent hypophosphatemia, phosphate levels were significantly associated with FGF23 and not with PTH. FGF23 is increased in children after PRT, especially in patients with chronic allograft dysfunction, and seems to be a more sensitive marker of dysregulated calcium phosphate homeostasis than PTH.
AB - FGF23 is a circulating factor regulating TPR and is increased in CKD. After RT, it seems to induce phosphorus wasting in adults. Data on FGF23 after PRT are scarce. Parameters of bone metabolism including calcium, phosphate, 25-(OH) vitamin D, 1,25-(OH)(2) vitamin D, alkaline phosphatase, PTH, and FGF23 were analyzed in 57 children after PRT and 11 controls. Median time after PRT was 25.9 (range 2-135) months. eGFR after PRT ranged from 15 to 175 mL/min/1.73 qm. Mean (±s.e.) FGF23 and PTH levels were significantly elevated compared with controls (146 ± 30 vs. 43 ± 3 ng/L, p = 0.001 and 182 ± 42 vs. 74 ± 18 ng/L, p = 0.004, respectively). Highest FGF23 levels were found in children with an eGFR below 60 mL/min*1.73 sqm (280 ± 69 vs. 62 ± 5 ng/L, p = 0.001), but significantly elevated values were already present in CKD2T. In a multivariate analysis, eGFR, PTH, calcium, and phosphate were significantly associated with FGF23. In a subgroup of 17 patients (29.8%) with persistent hypophosphatemia, phosphate levels were significantly associated with FGF23 and not with PTH. FGF23 is increased in children after PRT, especially in patients with chronic allograft dysfunction, and seems to be a more sensitive marker of dysregulated calcium phosphate homeostasis than PTH.
KW - Humans
KW - Male
KW - Female
KW - Adolescent
KW - Multivariate Analysis
KW - Treatment Outcome
KW - Child
KW - Cross-Sectional Studies
KW - Child, Preschool
KW - Infant
KW - Case-Control Studies
KW - Biological Markers/blood
KW - Kidney Transplantation
KW - Calcium Phosphates/blood
KW - Fibroblast Growth Factors/blood
KW - Homeostasis
KW - Hypophosphatemia/blood/etiology
KW - Kidney Failure, Chronic/blood/surgery
KW - Parathyroid Hormone/blood
KW - Postoperative Complications/blood
KW - Vitamin D/analogs & derivatives/blood
KW - Humans
KW - Male
KW - Female
KW - Adolescent
KW - Multivariate Analysis
KW - Treatment Outcome
KW - Child
KW - Cross-Sectional Studies
KW - Child, Preschool
KW - Infant
KW - Case-Control Studies
KW - Biological Markers/blood
KW - Kidney Transplantation
KW - Calcium Phosphates/blood
KW - Fibroblast Growth Factors/blood
KW - Homeostasis
KW - Hypophosphatemia/blood/etiology
KW - Kidney Failure, Chronic/blood/surgery
KW - Parathyroid Hormone/blood
KW - Postoperative Complications/blood
KW - Vitamin D/analogs & derivatives/blood
M3 - SCORING: Journal article
VL - 16
SP - 443
EP - 450
JO - PEDIATR TRANSPLANT
JF - PEDIATR TRANSPLANT
SN - 1397-3142
IS - 5
M1 - 5
ER -
