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Correlation between serum levels of Fibroblast Growth Factor-23 (FGF-23) and parathyroid hormone levels in predialysis Chronic Kidney Disease (CKD) patients at Sanglah General Hospital, Bali, Indonesia

  • Ivan Master Worung ,
  • Anak Agung Wiradewi Lestari ,
  • Yenny Kandarini ,
  • I Nyoman Wande ,
  • Ida Ayu Putri Wirawati ,
  • Ni Nyoman Mahartini ,

Abstract

Backgrounds: Chronic kidney disease (CKD) is an abnormality in the kidney that lasts for more than 3 months. Increased phosphate levels in the blood due to CKD will stimulate the secretion of Fibroblast Growth Factor 23 (FGF-23). Increased secretion of FGF-23 happens to maintain phosphate balance because the capacity of excretion of phosphorus in the kidneys decreases and leads to the incidence of secondary hyperparathyroidism due to Parathyroid Hormone (PTH). This study aims to evaluate the relationship between serum levels of FGF-23 and PTH in predialysis CKD patients.

Methods: An analytical observational study with a cross-sectional approach has been conducted in this study from August until October 2020. Analysis of the relationship between serum levels of Fibroblast Growth Factor (FGF-23) and intact parathyroid hormone using the Spearman correlation test with a significance level of =0.05. Data were analyzed using SPSS version 17 for Windows.

Results: A total of 75 people consisting of 49 male participants (65.3%) and 26 female participants (34.7%). The normality test showed that the data were not normally distributed (p<0.05), so the Spearman correlation test was used to evaluate the relationship between FGF-23 and intact PTH. The statistical analysis results showed a low significant positive correlation (r=0.168; p=0.046) between serum levels of FGF-23 and serum levels of intact PTH.

Conclusion: There was a low significant positive correlation between FGF-23 and PTH serum levels in predialysis CKD patients.

References

  1. Webster AC, Nagler EV, Morton RL, Masson P. Chronic Kidney Disease. Lancet. 2017;389(10075):1238-1252.
  2. Ma L, Zhao S. Risk factors for mortality in patients undergoing hemodialysis: A systematic review and meta-analysis. Int J Cardiol. 2017;238:151-158.
  3. GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-733.
  4. Trihono PP, Rhodia L, Karyanti MR. Kidney Disease Profiles Among Adolescents In Indonesia. Acta Med Indones. 2018;50(4):283-290.
  5. RSUP Sanglah. Laporan Pelayanan Instalasi Rawat Jalan Bulan Mei tahun 2019 RSUP Sanglah Denpasar. 2019.
  6. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl (2011). 2017;7(1):1-59.
  7. Herawati S, Kandarini Y, Prabawa IPY. The Correlation between Estimated Glomerular Filtration Rate and Parathyroid Hormone Levels in Predialysis-chronic Kidney Disease Adult Patients at Sanglah General Hospital, Bali, Indonesia. Open Access Macedonian Journal of Medical Sciences. 2021;9(B):470-474.
  8. Moe SM, Chertow GM, Parfrey PS, Kubo Y, Block GA, Correa-Rotter R, Drüeke TB, et al. Cinacalcet, Fibroblast Growth Factor-23, and Cardiovascular Disease in Hemodialysis: The Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial. Circulation. 2015;132(1):27-39.
  9. van Helden J, Weiskirchen R. Technical and diagnostic performance of a new fully automated immunoassay for the determination of intact fibroblast growth factor 23 (FGF23). Scand J Clin Lab Invest. 2018;78(7-8):584-590.
  10. Borrelli S, Chiodini P, De Nicola L, Minutolo R, Provenzano M, Garofalo C, et al. Prognosis and determinants of serum PTH changes over time in 1-5 CKD stage patients followed in tertiary care. PLoS One. 2018;13(8):e0202417.
  11. Ahmadi F, Mohebbi Z, Mahdavi-Mazdeh M, Lessan-Pezeshki M. Relationship of Circulating Levels of 25(OH) Vitamin D with Parathyroid Hormone in Iranian Patients with Chronic Kidney Disease not yet on Dialysis; What is the Best Threshold for 25(OH) Vitamin D. Journal of Parathyroid Disease. 2017;5(2):32–37.
  12. Andress DL, Coyne DW, Kalantar-Zadeh K, Molitch ME, Zangeneh F, Sprague SM. Management of secondary hyperparathyroidism in stages 3 and 4 chronic kidney disease. Endocr Pract. 2008;14(1):18-27.
  13. Cunningham J, Locatelli F, Rodriguez M. Secondary hyperparathyroidism: pathogenesis, disease progression, and therapeutic options. Clin J Am Soc Nephrol. 2011;6(4):913-921.
  14. Cardoso MP, Pereira LAL. Native vitamin D in pre-dialysis chronic kidney disease. Nefrologia (Engl Ed). 2019;39(1):18-28.
  15. Fraser SD, Blakeman T. Chronic kidney disease: identification and management in primary care. Pragmat Obs Res. 2016;7:21-32.
  16. Damtie S, Biadgo B, Baynes HW, et al. Chronic Kidney Disease and Associated Risk Factors Assessment among Diabetes Mellitus Patients at A Tertiary Hospital, Northwest Ethiopia. Ethiop J Health Sci. 2018;28(6):691-700.
  17. Moorthi RN, Moe SM. CKD-mineral and bone disorder: core curriculum 2011. Am J Kidney Dis. 2011;58(6):1022-1036.
  18. Goltzman D. Physiology of Parathyroid Hormone. Endocrinol Metab Clin North Am. 2018;47(4):743-758.
  19. Fragoso A, Silva AP, Gundlach K, Büchel J, Neves PL. Magnesium and FGF-23 are independent predictors of pulse pressure in pre-dialysis diabetic chronic kidney disease patients. Clin Kidney J. 2014;7(2):161-166.
  20. Marsell R, Grundberg E, Krajisnik T, Mallmin H, Karlsson M, Mellström D, et al. Fibroblast growth factor-23 is associated with parathyroid hormone and renal function in a population-based cohort of elderly men. Eur J Endocrinol. 2008;158(1):125-129.
  21. Gutierrez O, Isakova T, Rhee E, et al. Fibroblast growth factor-23 mitigates hyperphosphatemia but accentuates calcitriol deficiency in chronic kidney disease. J Am Soc Nephrol. 2005;16(7):2205-2215.
  22. Larsson T, Nisbeth U, Ljunggren O, Jüppner H, Jonsson KB. Circulating concentration of FGF-23 increases as renal function declines in patients with chronic kidney disease, but does not change in response to variation in phosphate intake in healthy volunteers. Kidney Int. 2003;64(6):2272-2279.
  23. Fliser D, Kollerits B, Neyer U, Ankerst DP, Lhotta K, Lingenhel A, et al. Fibroblast growth factor 23 (FGF23) predicts progression of chronic kidney disease: the Mild to Moderate Kidney Disease (MMKD) Study. J Am Soc Nephrol. 2007;18(9):2600-8.
  24. Villa-Bellosta R, Rodriguez-Osorio L, Mas S, Abadi Y, Rubert M, de la Piedra C, et al. A decrease in intact parathyroid hormone (iPTH) levels is associated with higher mortality in prevalent hemodialysis patients. PLoS One. 2017;12(3):e0173831.
  25. Silva AP, Gundlach K, Büchel J, Jerónimo T, Fragoso A, Silva C, et al. Low Magnesium Levels and FGF-23 Dysregulation Predict Mitral Valve Calcification as well as Intima Media Thickness in Predialysis Diabetic Patients. Int J Endocrinol. 2015;2015:308190.
  26. Isakova T, Wahl P, Vargas GS, Gutiérrez OM, Scialla J, Xie H, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011;79(12):1370-8.
  27. Sliem H, Tawfik G, Moustafa F, Zaki H. Relationship of associated secondary hyperparathyroidism to serum fibroblast growth factor-23 in end stage renal disease: a case-control study. Indian J Endocrinol Metab. 2011;15(2):105-109.
  28. Silver J, Rodriguez M, Slatopolsky E. FGF23 and PTH--double agents at the heart of CKD. Nephrol Dial Transplant. 2012;27(5):1715-1720.

How to Cite

Worung, I. M., Lestari, A. A. W., Kandarini, Y., Wande, I. N., Wirawati, I. A. P., & Mahartini, N. N. (2021). Correlation between serum levels of Fibroblast Growth Factor-23 (FGF-23) and parathyroid hormone levels in predialysis Chronic Kidney Disease (CKD) patients at Sanglah General Hospital, Bali, Indonesia. Bali Medical Journal, 10(2), 830–834. https://doi.org/10.15562/bmj.v10i2.2527

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Ivan Master Worung
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Pubmed
BMJ Journal


Anak Agung Wiradewi Lestari
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Yenny Kandarini
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I Nyoman Wande
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Ida Ayu Putri Wirawati
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Ni Nyoman Mahartini
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BMJ Journal