Background
Methods
Study population
Analytical validation of FGF-23 assay
Data analysis
Results
Diagnosis | Number | Overall % | % CKD stage I | % CKD stage II | % CKD stage III | % CKD stage IV+V |
---|---|---|---|---|---|---|
Cystic | 4 | 4.9% | 2.3% | 0.0% | 7.7% | 15.4% |
Tubular | 14 | 17.3% | 20.5% | 27.3% | 15.4% | 0.0% |
Glomerular | 34 | 42.0% | 59.1% | 36.4% | 7.7% | 23.1% |
Uropathy | 17 | 21.0% | 13.6% | 18.2% | 23.1% | 46.2% |
Renal dysplasia | 12 | 14.8% | 4.5% | 18.2% | 46.2% | 15.4% |
CKD stage | CKD stage I | CKD stage II | CKD stage III | CKD stage IV+V |
---|---|---|---|---|
Number of patients | 44 | 11 | 13 | 13 |
% of total patients | 54.3% | 13.6% | 16.0% | 16.0% |
Median GFR (IQR 25th-75th percentile) | 141.3 (105.1-161.9) | 71.3 (65.8-82.8) | 43.5 (36.4-5.9) | 15.3 (11.7-20.4) |
Renal acidosis
| ||||
Overall treated | 11.4% | 0.0% | 30.8% | 23.1% |
Treated with bicarbonate (%) | 2.3% | 0.0% | 23.1% | 23.1% |
Treated with potassium/sodium citrate (%) | 9.1% | 0.0% | 7.7% | 0.0% |
Hypertension
| ||||
Patients on any BP meds (%) | 54.5% | 72.7% | 46.2% | 76.9% |
Patients on ACE-I or ARB (%) | 43.2% | 72.7% | 53.8% | 46.2% |
Patients on non-ACE-I (diuretics, Ca-channel blocker etc.) (%) | 18.2% | 27.3% | 15.4% | 53.8% |
Patients on multiple therapies (%) | 22.7% | 36.4% | 15.4% | 23.1% |
Steroid therapy
| ||||
% of patients on corticosteroid medications | 18.2% | 18.2% | 7.7% | 7.7% |
% Renal osteodystrophy treated with
| ||||
calcium containing phosphate binders | 0.0% | 9.1% | 15.4% | 46.2% |
non-calcium containing phosphate binders | 0.0% | 0.0% | 0.0% | 15.4% |
vitamin D analog | 6.8% | 9.1% | 0.0% | 46.2% |
active vitamin D analog | 0.0% | 9.1% | 30.8% | 53.8% |
Abnormally high PTH (N=1.6-6.9 pmol/L) | 6.8% | 36.4% | 69.2% | 84.6% |
Abnormally high FGF-23 (N=10-50 pg/mL) | 13.6% | 27.3% | 53.8% | 92.3% |
Abnormally high phosphate (N=0.80-1.33 mmol/L) | 40.9% | 45.5% | 15.4% | 84.6% |
Correlations of CysC eGFR | Correlation coefficient | P-value | Correlations of FGF-23 | Correlation coefficient | P-value |
---|---|---|---|---|---|
❖ All patients FGF-23 | −0.4041 | <0.0001 | ❖ All patients CysC eGFR | −0.4041 | 0.0002 |
CKD Stage | −0.8939 | 0.7688 | CKD Stage | 0.4574 | < 0.0001 |
Calcium | 0.0332 | 0.0090 | Calcium | −0.2020 | 0.0705 |
Phosphate | −0.2887 | 0.0083 | Phosphate | 0.1791 | 0.1097 |
Ca*P | −0.2914 | 0.3484 | Ca*P | 0.1645 | 0.1422 |
25-OH Vit D | −0.1062 | <0.0001 | 25-OH Vit D | 0.0554 | 0.6253 |
125(OH)2 Vit D | 0.5926 | 0.0241 | 125(OH)2 Vit D | −0.3455 | 0.0034 |
Alk Phosph | −0.2603 | 0.0002 | Alk Phosph | −0.0858 | 0.4644 |
PTH | −0.5758 | 0.0002 | PTH | 0.3298 | 0.0039 |
ionized Ca | 0.4278 | <0.0001 | ionized Ca | −0.3301 | 0.0049 |
❖ < 13 yrs
| ❖ < 13 yrs
| ||||
FGF-23 | −0.0798 | 0.6388 | CysC eGFR | −0.0798 | 0.6388 |
CKD Stage | −0.8850 | <0.0001 | CKD Stage | 0.1054 | 0.5348 |
Calcium | 0.0684 | 0.6873 | Calcium | −0.1727 | 0.3067 |
Phosphate | 0.0649 | 0.7029 | Phosphate | −0.0324 | 0.8490 |
Ca*P | 0.0605 | 0.7221 | Ca*P | −0.0440 | 0.7960 |
25-OH Vit D | −0.3134 | 0.0589 | 25-OH Vit D | 0.1307 | 0.4405 |
125(OH)2 Vit D | 0.4281 | 0.0163 | 125(OH)2 Vit D | 0.1203 | 0.5193 |
Alk Phosph | −0.2764 | 0.1080 | Alk Phosph | −0.1290 | 0.4602 |
PTH | −0.4727 | 0.0048 | PTH | 0.1235 | 0.4864 |
ionized Ca | 0.4468 | 0.0081 | ionized Ca | −0.2085 | 0.2366 |
❖ > 13 yrs
| ❖ > 13 yrs
| ||||
FGF-23 | −0.6330 | <0.0001 | CysCeGFR | −0.6330 | <0.0001 |
CKD Stage | −0.8975 | <0.0001 | CKD Stage | 0.7309 | <0.0001 |
Calcium | 0.0135 | 0.9305 | Calcium | −0.1796 | 0.2435 |
Phosphate | −0.5558 | <0.0001 | Phosphate | 0.5570 | <0.0001 |
Ca*P | −0.5618 | <0.0001 | Ca*P | 0.5343 | <0.0001 |
25-OH Vit D | 0.0400 | 0.7990 | 25-OH Vit D | 0.0032 | 0.9835 |
125(OH)2 Vit D | 0.6888 | <0.0001 | 125(OH)2 Vit D | −0.6306 | <0.0001 |
Alk Phosph | −0.4289 | 0.0058 | Alk Phosph | 0.2834 | 0.0764 |
PTH | −0.6071 | <0.0001 | PTH | 0.4747 | 0.0017 |
ionized Ca | 0.4592 | 0.0042 | ionized Ca | −0.5034 | 0.0015 |
CKD stage | Calcium [mmol/L] | Phosphate [mmol/L] | 25-OH vitamin D [nmol/L] | 1,25 (OH)2 vitamin D [pmol/L] | Alkaline phosphatase [U/L] | intact PTH [pmol/L] | FGF-23 [pg/mL] |
---|---|---|---|---|---|---|---|
CKD stage I
| 2.32 (2.2-2.4) | 1.27 (1.1-1.4) | 61 (48.5-86.5) | 82 (70.5-100.5) | 153 (85.0-216.5) | 3.8 (2.8-4.8) | 39.4 (30.9-47.2) |
CKD stage II
| 2.39 (2.3-2.4) | 1.19 (1.2-1.4) | 45 (44–91) | 57 (46–73.5) | 153 (96–283) | 4.4 (3.3-7.8) | 45.2 (24.3-51.6) |
CKD stage III
| 2.36 (2.3-2.4) | 1.22 (1.2-1.3) | 64 (47–101) | 53.5 (41–64.2) | 218 (122.5-254) | 8.8 (7–9.3) | 52.8 (28.9 – 102.8) |
CKD stage IV+V
| 2.22 (2.1-2.4) | 2.06 (1.7-2.3) | 58.5 (47.5-127.2) | 17 (12–32.5) | 188 (102–261) | 44.4 (9.7-79.1) | 461.1 (158.4 – 666.8) |