Are fibroblast growth factor 23 concentrations in renal transplant patients different from non-transplanted chronic kidney disease patients?

Authors

  • Guido Filler,

    1. Department of Pediatrics, Children’s Hospital, London Health Science Centre, University of Western Ontario, London, ON, Canada
    2. Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
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  • Daisy Liu,

    1. Department of Pediatrics, Children’s Hospital, London Health Science Centre, University of Western Ontario, London, ON, Canada
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  • Ajay Parkash Sharma,

    1. Department of Pediatrics, Children’s Hospital, London Health Science Centre, University of Western Ontario, London, ON, Canada
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  • Joanne Grimmer

    1. Department of Pediatrics, Children’s Hospital, London Health Science Centre, University of Western Ontario, London, ON, Canada
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Guido Filler, Department of Paediatrics, University of Western Ontario, 800 Commissioners Road East, London, ON, Canada N6A 5W9
Tel.:+1 519 685 8377
Fax: +1 519 685 8156
E-mail: guido.filler@lhsc.on.ca

Abstract

Filler G, Liu D, Sharma AP, Grimmer J. Are fibroblast growth factor 23 concentrations in renal transplant patients different from non-transplanted chronic kidney disease patients?
Pediatr Transplantation 2012: 16: 73–77. © 2011 John Wiley & Sons A/S.

Abstract:  To compare the pattern of serum FGF23 levels in pediatric renal transplant recipients and GFR-matched controls. We performed a cross-sectional matched pair study in 19 stable pediatric renal transplant recipients and 19 GFR-matched controls with native CKD. After assessment for normal distribution, demographic and bone metabolism parameters were compared with Student’s t-test, Wilcoxon’s matched pairs (for non-normal distribution) test, and correlation analysis. The groups were comparable for anthropometric parameters, cystatin C eGFR (71.10 ± 37.28 vs. 76.11 ± 26.80 mL/min/1.73 m2), cystatin C, urea, creatinine, intact PTH, pH, CRP, alkaline phosphatase, phosphate, calcium, ionized calcium, FGF-23 (63.44 [IQR 38.42, 76.29], 49.92 [IQR 42.48, 76.97]), albumin, and urinary calcium/creatinine ratio. The renal transplant patients had significantly lower 25-(OH) vitamin D levels (66.63 ± 17.54 vs. 91.42 ± 29.16 ng/mL), and higher 1,25-(OH)2 vitamin D levels (95.78 ± 34.54 vs. 67.11 ± 35.90 pm). FGF-23 levels correlated negatively with cystatin C eGFR (r = −0.3571, p = 0.02770) and positively with PTH (r = 0.5063, p = 0.0026), but not with serum phosphate (r = 0.2651, p = 0.1077). We conclude that the increase in FGF23 levels with GFR decline in pediatric renal transplant patients remains similar to that in the patients with CKD. The relationship between FGF23 and serum vitamin D needs further evaluation.

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