Impact of Fibroblast Growth Factor 23 on Lipids and Atherosclerosis in Hemodialysis Patients
Eijin Ashikaga
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorCorresponding Author
Hirokazu Honda
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Dr Hirokazu Honda, Division of Nephrology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan. Email: [email protected]Search for more papers by this authorHiroki Suzuki
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorNozomu Hosaka
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorYuki Hirai
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorDaisuke Sanada
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorMari Nakamura
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorHisako Nagai
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorKei Matsumoto
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorNoriyuki Kato
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorMasanori Mukai
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorMakoto Watanabe
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorKeiko Takahashi
Internal Medicine, Kawasaki Clinic, Kawasaki, Japan
Search for more papers by this authorKanji Shishido
Internal Medicine, Kawasaki Clinic, Kawasaki, Japan
Search for more papers by this authorTadao Akizawa
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorEijin Ashikaga
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorCorresponding Author
Hirokazu Honda
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Dr Hirokazu Honda, Division of Nephrology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan. Email: [email protected]Search for more papers by this authorHiroki Suzuki
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorNozomu Hosaka
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorYuki Hirai
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorDaisuke Sanada
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorMari Nakamura
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorHisako Nagai
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorKei Matsumoto
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorNoriyuki Kato
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorMasanori Mukai
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorMakoto Watanabe
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorKeiko Takahashi
Internal Medicine, Kawasaki Clinic, Kawasaki, Japan
Search for more papers by this authorKanji Shishido
Internal Medicine, Kawasaki Clinic, Kawasaki, Japan
Search for more papers by this authorTadao Akizawa
Division of Nephrology, Department of Medicine, Showa University, Tokyo, and
Search for more papers by this authorAbstract
Levels of fibroblast growth factor (FGF) 23, a phosphatonin, are frequently elevated in patients with end-stage renal disease (ESRD) who are on maintenance hemodialysis (MHD). However, the role of FGF23 remains unclear because renal FGF receptor function might be impaired. The present cross-sectional study examines a cohort of patients (n = 196) on MHD who were not undergoing therapy with lipid-lowering drugs including sevelamer. Non-fasting venous blood samples were withdrawn before the hemodialysis (HD) session on the third day after the previous HD session to measure serum levels of albumin, calcium (Ca), phosphate (P), alkaline phosphatase, intact parathyroid hormone (PTH), total cholesterol (C), high-density lipoprotein (HDL)-C, low-density lipoprotein(LDL)-C, oxidative LDL-C, high-sensitivity C-reactive protein (HsCRP), interleukin-6 (IL-6), and FGF23. Nutritional status was assessed using the geriatric nutritional risk index (GNRI). Carotid intima-medial thickness (CIMT) was assessed using a B-mode ultrasound scanner. FGF23 was positively correlated with P, Caalb×P product, and intact PTH, and inversely correlated with C and non-HDL-C. In the higher FGF23 tertile, levels of both non-HDL-C and C were significantly decreased and CIMT was less elevated compared to the lower FGF23 tertile. Multivariate analysis showed that the higher FGF23 tertile was independently associated with decreases in C (adjusted r2 = 0.14) and non-HDL-C (adjusted r2 = 0.20) levels and with a less-pronounced increase in CIMT (adjusted r2 = 0.14). High FGF23 appears to be an independent biomarker of a decrease in C and non-HDL-C that is negatively associated with atherosclerosis in patients on MHD.
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