[Home ] [Archive]   [ فارسی ]  
:: Main :: About :: Current Issue :: Archive :: Search :: Submit :: Contact ::
:: Volume 30, Issue 1 (3-2022) ::
Journal of Ilam University of Medical Sciences 2022, 30(1): 65-73 Back to browse issues page
Correlation between Fibroblast Growth Factor 23 and C-reactive Protein in Hemodialysis Patients
Elham Ramezanzade1 , Salman Nikfarjam * 2, Masoomeh Namdar1, Fatemeh Nejatifar3
1- Dept of Nephrology, Razi Clinical Research Development Unit, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
2- Dept of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran , dr.cardiolog58@yahoo.com
3- Razi Clinical Research Development Unit, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Abstract:   (905 Views)
Introduction: Fibroblast growth factor 23 (FGF23) levels and inflammatory markers are usually elevated in End-Stage Renal Disease ESRD, and each is associated with adverse clinical outcomes. This study aimed to investigate the hypothesis that FGF23 was independently associated with C-reactive protein in ESRD.
Material & Methods: This cross-sectional study was performed on 254 ESRD patients undergoing hemodialysis. The sampling method was census so that all ESRD patients undergoing hemodialysis in the hemodialysis center of Razi Hospital, Rasht, Iran, in 2017, were included in the study. Data analysis was performed using SPSS software (version 26) through the Shapiro-Wilk test, Spearman correlation multiplication, and linear regression.
(Ethic code: IR.GUMS.REC.1396.123)
Findings: The median age of the patients was 60 years (age range: 49-69), and 57.9% of the cases were male. The mean and median amount of iFGF23 in patients were 59.5±14.6 and 62 pg/ml (50-70), respectively. Moreover, the median amount of CRP factor was 4 mg/l (1-11). The percentage of positive CRP in the studied patients was 72.9%, while the mean amount and standard deviation in the positive cases were 12.94±8.82. In multiple linear regression analysis, after controlling the effect of confounding variables (individual variables, blood parameters, and underlying diseases), there was a direct and significant relationship between iFGF23 and CRP (P=0.010, 𝜷=0.129, CI=0.032-0.226).
Discussion & Conclusion: The present study showed that increased FGF23 levels are independently associated with increased CRP levels in patients with ESRD. Future studies should evaluate whether inflammation alters the association between elevated FGF23 levels and adverse clinical outcomes in ESRD.
Keywords: C-reactive protein, End-stage renal disease, Fibroblast growth factor-23, Hemodialysis patients
Full-Text [PDF 1227 kb]   (262 Downloads)    
Type of Study: Research | Subject: General
Received: 2021/10/15 | Accepted: 2021/12/21 | Published: 2023/03/6
1. Sugimoto H, Ogawa T, Iwabuchi Y, Otsuka K, Nitta K. Relationship between serum fibroblast growth factor-23 level and mortality in chronic hemodialysis patients. Int Urol and Nephrol 2014; 46:1:99-106. [DOI:10.1007/s11255-013-0386-2]
2. Schnedl C, Fahrleitner-Pammer A, Pietschmann P, Amrein K. FGF23 in acute and chronic illness. Dis Markers. 2015; 2015. [DOI:10.1155/2015/358086]
3. Gutierrez O, Isakova T, Rhee E, Shah A, Holmes J, Collerone G, et al. Fibroblast growth factor-23 mitigates hyperphosphatemia but accentuates calcitriol deficiency in chronic kidney disease. Am Soc Nephrol 2005; 16:7:2205-15. [DOI:10.1681/ASN.2005010052]
4. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007; 50:1:40-7. https://doi:10.1016/j.jacc.2007.02.067
5. Ridker PM, Silvertown JD. Inflammation, C-reactive protein, and atherothrombosis. J Periodontol. 2008; 79(8 Suppl):1544-51. [DOI:10.1902/jop.2008.080249]
6. Agrawal A. CRP after 2004. Mol Immunol.2005; 42(8): 927-30.
7. Yeh ET. CRP as a mediator of disease. Circulation. 2004; 109(21_suppl_1): II11-II14. [DOI:10.1161/01.CIR.0000129507.12719.80]
8. Gluba-Brzózka A, Franczyk B, Olszewski R, Rysz J. The influence of inflammation on anemia in CKD patients. Int J Mol Sci .2020; 21:3:725. [DOI:10.3390/ijms21030725]
9. Gutiérrez OM, Mannstadt M, Isakova T, Rauh-Hain JA, Tamez H, Shah A, at al. Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis. N Engl J Med. 2008; 359:6:584-92. [DOI:10.1056/NEJMoa0706130]
10. Menon V, Greene TO, Wang X, Pereira AA, Marcovina SM, Beck GJ, et al. C-reactive protein and albumin as predictors of all-cause and cardiovascular mortality in chronic kidney disease. Kidney int. 2005; 68:2:766-72. [DOI:10.1111/j.1523-1755.2005.00455.x]
11. Stenvinkel P, Alvestrand A. Review articles: inflammation in end‐stage renal disease: sources, consequences, and therapy. Semin Dial. 2002; 15:5: 329-337. [DOI:10.1046/j.1525-139X.2002.00083.x]
12. Manghat P, Fraser WD, Wierzbicki AS, Fogelman I, Goldsmith DJ, Hampson G. Fibroblast growth factor-23 is associated with C-reactive protein, serum phosphate and bone mineral density in chronic kidney disease. Osteoporos Int. 2010; 21:11:1853-61. [DOI:10.1007/s00198-009-1142-4.]
13. Jean G, Terrat JC, Vanel T, Hurot JM, Lorriaux C, Mayor B, Chazot C. High levels of serum fibroblast growth factor (FGF)-23 are associated with increased mortality in long haemodialysis patients. Nephrol Dial Transplant. 2009; 24:9:2792-6. [DOI:10.1093/ndt/gfp191]
14. Mizuiri S, Nishizawa Y, Yamashita K, Ono K, Oda M, Usui K, et al. Lower serum fibroblast growth factor‐23 levels may suggest malnutrition in maintenance haemodialysis patients. Nephrology. 2014; 19:9:568-73. [DOI:10.1111/nep.12290]
15. Hsu JJ, Katz R, Ix JH, de Boer IH, Kestenbaum B, Shlipak MG. Association of fibroblast growth factor-23 with arterial stiffness in the Multi-Ethnic Study of Atherosclerosis. Nephrol Dial Transplant. 2014; 29:11:2099-105. [DOI:10.1093/ndt/gfu101]
16. Marsell R, Grundberg E, Krajisnik T, Mallmin H, Karlsson M, Mellstrom 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; 158:1:125-30. [DOI:10.1530/EJE-07-0534]
17. van Breda F, Emans ME, van der Putten K, Braam B, van Ittersum FJ, Kraaijenhagen RJ, et al. Relation between red cell distribution width and fibroblast growth factor 23 cleaving in patients with chronic kidney disease and heart failure. PLoS One. 2015; 10:6:e0128994. [DOI:10.1371/journal.pone.0128994]
18. Ashikaga E, Honda H, Suzuki H, Hosaka N, Hirai Y, Sanada D, et al. Impact of fibroblast growth factor 23 on lipids and atherosclerosis in hemodialysis patients. Ther Apher Dial. 2010; 14:3:315-22. [DOI:10.1111/j.1744-9987.2009.00796.x]
19. Moe SM, Chen NX. Inflammation and vascular calcification. Blood purification. 2005;23:1:64-71. [DOI:10.1159/000082013]
20. Desjardins L, Liabeuf S, Renard C, Lenglet A, Lemke HD, Choukroun G, et al. FGF23 is independently associated with vascular calcification but not bone mineral density in patients at various CKD stages. Osteoporosis Int. 2012; 23:7:2017-25. [DOI:10.1007/s00198-011-1838-0]
21. Jean G, Bresson E, Terrat JC, Vanel T, Hurot JM, Lorriaux C, et al. Peripheral vascular calcification in long-haemodialysis patients: associated factors and survival consequences. Nephrol Dial Transplant. 2009; 24:3:948-55. [DOI:10.1093/ndt/gfn571]
22. Hasegawa H, Nagano N, Urakawa I, Yamazaki Y, Iijima K, Fujita T, et al. Direct evidence for a causative role of FGF23 in the abnormal renal phosphate handling and vitamin D metabolism in rats with early-stage chronic kidney disease. Kidney int. 2010; 78:10:975-80. [DOI:10.1038/ki.2010.313]
23. Shimada T, Hasegawa H, Yamazaki Y, Muto T, Hino R, Takeuchi Y, et al. FGF‐23 is a potent regulator of vitamin D metabolism and phosphate homeostasis. J Bone Miner Res. 2004; 19:3:429-35. https://doi.org /10.1359/JBMR.0301264
24. Isakova T, Gutiérrez OM, Patel NM, Andress DL, Wolf M, Levin A. Vitamin D deficiency, inflammation, and albuminuria in chronic kidney disease: complex interactions. J Ren Nut. 2011; 1;21:4:295-302. [DOI:10.1053/j.jrn.2010.07.002]
25. Alborzi P, Patel NA, Peterson C, Bills JE, Bekele DM, Bunaye Z, et al. Paricalcitol reduces albuminuria and inflammation in chronic kidney disease: a randomized double-blind pilot trial. Hypertension. 2008; 52:2:249-55. [DOI:10.1161/HYPERTENSIONAHA.108.113159]
26. Faul C, Amaral AP, Oskouei B, Hu MC, Sloan A, Isakova T, et al. FGF23 induces left ventricular hypertrophy. J Clin Invest. 2011; 121:11:4393-408. [DOI:10.1172/JCI46122.]
27. Kurosu H, Choi M, Ogawa Y, Dickson AS, Goetz R, Eliseenkova AV, et al. Tissue-specific expression of βKlotho and fibroblast growth factor (FGF) receptor isoforms determines metabolic activity of FGF19 and FGF21. J Biol Chem. 2007; 282:37:26687-95. [DOI:10.1074/jbc.M704165200]
28. Castell JV, Gómez-Lechón MJ, David M, Andus T, Geiger T, Trullenque R, et al. Interleukin‐6 is the major regulator of acute phase protein synthesis in adult human hepatocytes. FEBS letters. 1989; 242:2:237-9. https://doi.org 10.1016/0014-5793(89)80476-4
29. Maekawa Y, Ishikawa K, Yasuda O, Oguro R, Hanasaki H, Kida I, et al. Klotho suppresses TNF-α-induced expression of adhesion molecules in the endothelium and attenuates NF-κB activation. Endocrine. 2009; 35:3:341-6. [DOI:10.1007/s12020-009-9181-3]
30. Zivarpour P, Zargari F. Klotho protein as a diagnostic biomarker in chronic kidney disease. Razi J Med Sci. 2020; 27:2:91-102.
Send email to the article author

Add your comments about this article
Your username or Email:


Ethics code: IR.GUMS.REC.1396.123

XML   Persian Abstract   Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ramezanzade E, Nikfarjam S, Namdar M, nejatifar F. Correlation between Fibroblast Growth Factor 23 and C-reactive Protein in Hemodialysis Patients. sjimu 2022; 30 (1) :65-73
URL: http://sjimu.medilam.ac.ir/article-1-7316-en.html

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 30, Issue 1 (3-2022) Back to browse issues page
مجله دانشگاه علوم پزشکی ایلام Journal of Ilam University of Medical Sciences
Persian site map - English site map - Created in 0.15 seconds with 30 queries by YEKTAWEB 4509