Skip to main content

Fibroblast Growth Factor 23 Levels Associate with AKI and Death in Critical Illness.

Publication ,  Journal Article
Leaf, DE; Jacob, KA; Srivastava, A; Chen, ME; Christov, M; Jüppner, H; Sabbisetti, VS; Martin, A; Wolf, M; Waikar, SS
Published in: J Am Soc Nephrol
June 2017

Elevated plasma levels of the osteocyte-derived hormone fibroblast growth factor 23 (FGF23) have emerged as a powerful biomarker of cardiovascular disease and death in patients with CKD. Whether elevated urinary or plasma FGF23 levels are prospectively associated with AKI and death in critically ill patients is unknown. We therefore conducted a prospective cohort study of 350 critically ill patients admitted to intensive care units at an academic medical center to investigate whether higher urinary FGF23 levels associate with the composite end point of AKI or in-hospital mortality (AKI/death). We measured urinary FGF23 levels within 24 hours of admission to the intensive care unit. In a subcohort (n=131) we also measured plasma levels of FGF23, calcium, phosphate, parathyroid hormone, and vitamin D metabolites. Urinary and plasma FGF23 levels, but not other mineral metabolites, significantly associated with AKI/death. In multivariate analyses, patients in the highest compared with the lowest quartile of urinary FGF23 had a 3.9 greater odds (95% confidence interval, 1.6 to 9.5) of AKI/death. Higher urinary FGF23 levels also independently associated with greater hospital, 90-day, and 1-year mortality; longer length of stay; and several other important adverse outcomes. In conclusion, elevated FGF23 levels measured in the urine or plasma may be a promising novel biomarker of AKI, death, and other adverse outcomes in critically ill patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Soc Nephrol

DOI

EISSN

1533-3450

Publication Date

June 2017

Volume

28

Issue

6

Start / End Page

1877 / 1885

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23
  • Female
  • Critical Illness
  • Biomarkers
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Leaf, D. E., Jacob, K. A., Srivastava, A., Chen, M. E., Christov, M., Jüppner, H., … Waikar, S. S. (2017). Fibroblast Growth Factor 23 Levels Associate with AKI and Death in Critical Illness. J Am Soc Nephrol, 28(6), 1877–1885. https://doi.org/10.1681/ASN.2016080836
Leaf, David E., Kirolos A. Jacob, Anand Srivastava, Margaret E. Chen, Marta Christov, Harald Jüppner, Venkata S. Sabbisetti, Aline Martin, Myles Wolf, and Sushrut S. Waikar. “Fibroblast Growth Factor 23 Levels Associate with AKI and Death in Critical Illness.J Am Soc Nephrol 28, no. 6 (June 2017): 1877–85. https://doi.org/10.1681/ASN.2016080836.
Leaf DE, Jacob KA, Srivastava A, Chen ME, Christov M, Jüppner H, et al. Fibroblast Growth Factor 23 Levels Associate with AKI and Death in Critical Illness. J Am Soc Nephrol. 2017 Jun;28(6):1877–85.
Leaf, David E., et al. “Fibroblast Growth Factor 23 Levels Associate with AKI and Death in Critical Illness.J Am Soc Nephrol, vol. 28, no. 6, June 2017, pp. 1877–85. Pubmed, doi:10.1681/ASN.2016080836.
Leaf DE, Jacob KA, Srivastava A, Chen ME, Christov M, Jüppner H, Sabbisetti VS, Martin A, Wolf M, Waikar SS. Fibroblast Growth Factor 23 Levels Associate with AKI and Death in Critical Illness. J Am Soc Nephrol. 2017 Jun;28(6):1877–1885.

Published In

J Am Soc Nephrol

DOI

EISSN

1533-3450

Publication Date

June 2017

Volume

28

Issue

6

Start / End Page

1877 / 1885

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23
  • Female
  • Critical Illness
  • Biomarkers