Fibroblast growth factor 23 and left ventricular hypertrophy in children on dialysis

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Abstract

Background: Elevated fibroblast growth factor 23 (FGF-23) concentrations associate with left ventricular hypertrophy (LVH) and adverse outcomes in adult patients with chronic kidney disease. We hypothesized that similar associations are present in pediatric patients on maintenance hemodialysis. Methods: In this retrospective study of 26 young patients on chronic hemodialysis, aged 6-21 years, cardiac structure and geometry were measured by echocardiography, and circulating levels of FGF-23 and calciotropic hormones were obtained. Results: FGF-23 levels were uniformly elevated in all patients from three- to 835-fold above the upper limit of normal. The average LV mass index (LVMI) was 43∈±∈13 g/m2.7 and reflected LVH in 55 % of patients. Log-transformed FGF-23 concentrations correlated with LVMI (p∈=∈0.03) and were independently associated with the interventricular septal thickness Z-score (p∈<∈0.001). Concentric LVH was associated with the highest FGF-23 concentrations and the highest LVMI measurements (p∈<∈0.001). Each 1 standard deviation increase in log-transformed FGF-23 levels was associated with a 17 % increase in LVMI. Conclusions: FGF-23 levels are strongly associated with increased LVMI and with prevalent LVH in pediatric hemodialysis patients. Our cross-sectional findings provide observational evidence supporting the hypothesis linking FGF-23 to cardiac hypertrophy in patients with chronic kidney disease.

Original languageEnglish
Pages (from-to)2129-2136
Number of pages8
JournalPediatric Nephrology
Volume27
Issue number11
DOIs
StatePublished - Nov 1 2012

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Left Ventricular Hypertrophy
Dialysis
Renal Dialysis
Chronic Renal Insufficiency
Pediatrics
fibroblast growth factor 23
Cardiomegaly
Echocardiography
Retrospective Studies
Maintenance
Hormones

Keywords

  • Cardiac hypertrophy
  • Cardiovascular disease
  • FGF-23
  • Hemodialysis
  • Mineral disorder

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Fibroblast growth factor 23 and left ventricular hypertrophy in children on dialysis",
abstract = "Background: Elevated fibroblast growth factor 23 (FGF-23) concentrations associate with left ventricular hypertrophy (LVH) and adverse outcomes in adult patients with chronic kidney disease. We hypothesized that similar associations are present in pediatric patients on maintenance hemodialysis. Methods: In this retrospective study of 26 young patients on chronic hemodialysis, aged 6-21 years, cardiac structure and geometry were measured by echocardiography, and circulating levels of FGF-23 and calciotropic hormones were obtained. Results: FGF-23 levels were uniformly elevated in all patients from three- to 835-fold above the upper limit of normal. The average LV mass index (LVMI) was 43∈±∈13 g/m2.7 and reflected LVH in 55 {\%} of patients. Log-transformed FGF-23 concentrations correlated with LVMI (p∈=∈0.03) and were independently associated with the interventricular septal thickness Z-score (p∈<∈0.001). Concentric LVH was associated with the highest FGF-23 concentrations and the highest LVMI measurements (p∈<∈0.001). Each 1 standard deviation increase in log-transformed FGF-23 levels was associated with a 17 {\%} increase in LVMI. Conclusions: FGF-23 levels are strongly associated with increased LVMI and with prevalent LVH in pediatric hemodialysis patients. Our cross-sectional findings provide observational evidence supporting the hypothesis linking FGF-23 to cardiac hypertrophy in patients with chronic kidney disease.",
keywords = "Cardiac hypertrophy, Cardiovascular disease, FGF-23, Hemodialysis, Mineral disorder",
author = "Wacharee Seeherunvong and Carolyn Abitbol and Jayanthi Chandar and Paolo Rusconi and Zilleruelo, {Gaston E} and Michael Freundlich",
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language = "English",
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T1 - Fibroblast growth factor 23 and left ventricular hypertrophy in children on dialysis

AU - Seeherunvong, Wacharee

AU - Abitbol, Carolyn

AU - Chandar, Jayanthi

AU - Rusconi, Paolo

AU - Zilleruelo, Gaston E

AU - Freundlich, Michael

PY - 2012/11/1

Y1 - 2012/11/1

N2 - Background: Elevated fibroblast growth factor 23 (FGF-23) concentrations associate with left ventricular hypertrophy (LVH) and adverse outcomes in adult patients with chronic kidney disease. We hypothesized that similar associations are present in pediatric patients on maintenance hemodialysis. Methods: In this retrospective study of 26 young patients on chronic hemodialysis, aged 6-21 years, cardiac structure and geometry were measured by echocardiography, and circulating levels of FGF-23 and calciotropic hormones were obtained. Results: FGF-23 levels were uniformly elevated in all patients from three- to 835-fold above the upper limit of normal. The average LV mass index (LVMI) was 43∈±∈13 g/m2.7 and reflected LVH in 55 % of patients. Log-transformed FGF-23 concentrations correlated with LVMI (p∈=∈0.03) and were independently associated with the interventricular septal thickness Z-score (p∈<∈0.001). Concentric LVH was associated with the highest FGF-23 concentrations and the highest LVMI measurements (p∈<∈0.001). Each 1 standard deviation increase in log-transformed FGF-23 levels was associated with a 17 % increase in LVMI. Conclusions: FGF-23 levels are strongly associated with increased LVMI and with prevalent LVH in pediatric hemodialysis patients. Our cross-sectional findings provide observational evidence supporting the hypothesis linking FGF-23 to cardiac hypertrophy in patients with chronic kidney disease.

AB - Background: Elevated fibroblast growth factor 23 (FGF-23) concentrations associate with left ventricular hypertrophy (LVH) and adverse outcomes in adult patients with chronic kidney disease. We hypothesized that similar associations are present in pediatric patients on maintenance hemodialysis. Methods: In this retrospective study of 26 young patients on chronic hemodialysis, aged 6-21 years, cardiac structure and geometry were measured by echocardiography, and circulating levels of FGF-23 and calciotropic hormones were obtained. Results: FGF-23 levels were uniformly elevated in all patients from three- to 835-fold above the upper limit of normal. The average LV mass index (LVMI) was 43∈±∈13 g/m2.7 and reflected LVH in 55 % of patients. Log-transformed FGF-23 concentrations correlated with LVMI (p∈=∈0.03) and were independently associated with the interventricular septal thickness Z-score (p∈<∈0.001). Concentric LVH was associated with the highest FGF-23 concentrations and the highest LVMI measurements (p∈<∈0.001). Each 1 standard deviation increase in log-transformed FGF-23 levels was associated with a 17 % increase in LVMI. Conclusions: FGF-23 levels are strongly associated with increased LVMI and with prevalent LVH in pediatric hemodialysis patients. Our cross-sectional findings provide observational evidence supporting the hypothesis linking FGF-23 to cardiac hypertrophy in patients with chronic kidney disease.

KW - Cardiac hypertrophy

KW - Cardiovascular disease

KW - FGF-23

KW - Hemodialysis

KW - Mineral disorder

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