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J Nephropathol. 2024;13(4): e20416.
doi: 10.34172/jnp.2024.20416
  Abstract View: 340
  PDF Download: 63

Original Article

Correlation of serum fibroblast growth factor-23 levels and calcium phosphate products levels in chronic kidney disease; sub analysis of chronic kidney disease-mineral and bone disorder study

Adeh Mahardika 1,2* ORCID logo, Hasyim Kasim 1 ORCID logo, Syakib Bakri 1 ORCID logo, Haerani Rasyid 1 ORCID logo, Husaini Umar 1 ORCID logo, Nu’man AS Daud 1 ORCID logo, Wasis Udaya 1 ORCID logo, Arifin Seweng 3 ORCID logo

1 Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
2 Department of Internal Medicine, Faculty of Medicine, Alkhairaat University, Palu, Indonesia
3 Department of Biostatistics, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
*Corresponding Author: Adeh Mahardika, Email: adehmahardika@gmail.com

Abstract

Introduction: The body produces fibroblast growth factor-23 (FGF-23) to maintain normal phosphate levels when hyperphosphatemia occurs. Production of FGF-23 indirectly causes hypocalcemia. Phosphate and calcium disturbances also occur in chronic kidney disease (CKD), therefore this adaptation mechanism applies. This situation; however, only manifests in the early stages of CKD; if the estimated glomerular filtration rate (eGFR) is less than 30% of normal. This adaptation is no longer adequate and levels of calcium-phosphate (Ca×P) products and FGF-23 still rise.

Objectives: In this study, the correlation between both the serum levels of FGF-23 and Ca×P products in CKD was analyzed.

Patients and Methods: A cross-sectional study including 78 subjects with CKD stages 3 to 5 dialysis was conducted. Serum FGF-23 levels were determined using the enzyme-linked immunosorbent assay (ELISA) method and Ca×P product levels were calculated using the formula calcium (mg/ dL) × phosphate (mg/dL). The Kolmogorov-Smirnov test and Spearman’s test were conducted in the statistical study. If the P value is less than 0.05, the statistical findings are significant.

Results: Serum FGF-23 levels and Ca×P product levels were shown to be significantly correlated. This analysis of the two correlations was independent of age and diabetes mellitus (DM). Based on stages of CKD, serum FGF-23 levels and Ca×P product levels were discovered to be significantly correlated only at stage 5 of non-dialysis.

Conclusion: Increasing serum FGF-23 levels were correlated with increased Ca×P product levels, particularly in CKD stage 5 non-dialysis subjects. This correlation was independent of age and DM.


Implication for health policy/practice/research/medical education:

In chronic kidney disease (CKD) with an estimated glomerular filtration rate (eGFR) of less than 30% of normal, serum fibroblast growth factor-23 (FGF-23) levels can rise together with Ca×P product values. According to our research, serum FGF-23 levels and calcium-phosphate (Ca×P) products levels were correlated, particularly in CKD stage 5 non-dialysis. It can be a benchmark for determining how CKD is progressing and diagnosing chronic kidney disease-mineral and bone disorder (CKD-MBD) by examining FGF-23, calcium and phosphate levels.

Please cite this paper as: Mahardika A, Kasim H, Bakri S, Rasyid H, Umar H, AS Daud N, Udaya W, Seweng A. Correlation of serum fibroblast growth factor-23 levels and calcium phosphate products levels in chronic kidney disease; sub analysis of chronic kidney disease-mineral and bone disorder study. J Nephropathol. 2024;13(4):e20416. DOI: 10.34172/jnp.2024.20416.

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Submitted: 17 Sep 2022
Accepted: 04 Jun 2023
ePublished: 07 May 2024
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