Introduction: Phosphate homeostasis disturbances, as well as higher circulating levels of fibroblast growth factor 23 (FGF-23), are an early consequence of CKD that can lead to a variety of bone disorders. For patients with various bone illnesses, treatment options are meant to keep calcium, phosphate, parathyroid hormone (PTH), and vitamin D levels within prescribed ranges. FGF 23 is currently not included in standard therapy protocols for the management of bone disorders in patients with CKD.
The study's main goal was to assess and connect FGF 23 levels in individuals with chronic kidney disease with calcium, phosphorus, vitamin D, and parathyroid hormone levels.
Secondary Goals: 1) Determine the relationship between haemoglobin levels and FGF 23 levels in patients with CKD at various stages.
2) To investigate differences in FGF 23 levels in patients with high and low turnover bone disease.
The working idea that FGF-23 is an indication of CKD development and related bone disorders was investigated. We wanted to see if it appeared earlier in the course of CKD than other markers including calcium, phosphate, PTH, and vitamin D. We included the occurrence of anaemia as an extra criteria to better understand FGF-23's 'off target' effects. We wanted to see how FGF 23 levels differed in high and low turnover bone illnesses, as well as how phosphate binders affected FGF 23 levels in these two types of bone diseases.
In 2015-16, Care Hospitals in Hyderabad, India, undertook an observational open label prospective study. It includes all adult patients with CKD who were chosen in order.
Results: A Kruskal Wallis test of 64 samples revealed no statistically significant difference in FGF23 levels between CKD stages. Between different phases of CKD, there was a statistically significant difference in haemoglobin levels. FGF 23 levels were higher in patients with a high turnover type of bone disease, but no statistical significance was found using the Wilcoxon Mann Whitney test. The findings of the chi-square test revealed that phosphate binders had a statistically significant influence on FGF 23 levels.
In a subgroup examination of high and low turnover bone disorders, FGF-23 and haemoglobin associated inversely. In low turnover bone disease, FGF 23 was lower, while in high turnover bone disease, it was higher. FGF 23 may be able to distinguish between high and low turnover bone disease, despite the fact that the link was statistically insignificant. The levels of intact FGF-23 in the blood did not have a statistically significant relationship with the course of CKD. Phosphate binders had a statistically significant effect in lowering FGF-23 levels.Author(S) Details
Girish Vasudeorao Kumthekar
Symbiosis University Hospital and Research Centre & Symbiosis Medical College for Women, Lavale, Pune, India.
Rajasekara Chakravarthi Madarasu
RENOWN Clinical Services, Hyderabad & Star Hospitals, Hyderabad, India.
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