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Erschienen in: Pediatric Nephrology 4/2016

01.04.2016 | Original Article

Effects of acute kidney injury and chronic hypoxemia on fibroblast growth factor 23 levels in pediatric cardiac surgery patients

verfasst von: Mark R. Hanudel, Katherine Wesseling-Perry, Barbara Gales, Georgina Ramos, Vicky Campbell, Kristen Ethridge, Mary Scotti, David A. Elashoff, Juan Alejos, Brian Reemtsen, Isidro B. Salusky

Erschienen in: Pediatric Nephrology | Ausgabe 4/2016

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Abstract

Background

Fibroblast growth factor-23 (FGF23) levels are elevated in cardiopulmonary bypass (CPB)-associated acute kidney injury (AKI); however, it is unknown how much of the circulating FGF23 is intact and bioactive. Hypoxia may induce FGF23 production, yet its impact in humans is unknown. Pediatric cardiac surgery patients have both a high incidence of CPB-associated AKI and a high prevalence of chronic hypoxemia.

Methods

We assessed the effects of hypoxemia and CPB-associated AKI on C-terminal FGF23 (cFGF23) and intact FGF23 (iFGF23) levels in 32 pediatric cardiac surgery patients with normal estimated glomerular filtration rate (eGFR). Plasma cFGF23 and iFGF23 were measured preoperatively and serially postoperatively.

Results

Despite normal renal and ventricular function, preoperative cFGF23 levels were high and elevated out of proportion to iFGF23 levels. Preoperative oxygen saturation measurements correlated inversely with FGF23 levels. Preoperative cFGF23 and oxygen saturation both predicted postoperative AKI. Postoperatively, cFGF23 and iFGF23 increased by 2 h postreperfusion; iFGF23 then returned to baseline, but cFGF23 remained elevated through 24 h postreperfusion. Group status (AKI vs. non-AKI) modified the effect of time on changes in iFGF23 levels but not cFGF23 levels.

Conclusions

Preoperative cFGF23 may predict CPB-associated kidney dysfunction. Changes over time in cFGF23 and iFGF23 levels post-CPB differ. Chronic hypoxemia may affect FGF23 production in humans.
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Metadaten
Titel
Effects of acute kidney injury and chronic hypoxemia on fibroblast growth factor 23 levels in pediatric cardiac surgery patients
verfasst von
Mark R. Hanudel
Katherine Wesseling-Perry
Barbara Gales
Georgina Ramos
Vicky Campbell
Kristen Ethridge
Mary Scotti
David A. Elashoff
Juan Alejos
Brian Reemtsen
Isidro B. Salusky
Publikationsdatum
01.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 4/2016
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-015-3257-5

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