Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease

Ki Heon Nam, Hyoungnae Kim, Seong Yeong An, Misol Lee, Min Uk Cha, Jung Tak Park, TaeHyun Yoo, Kyu Beck Lee, Yeong Hoon Kim, Su Ah Sung, Joongyub Lee, Shin-Wook Kang, Kyu Hun Choi, Curie Ahn, SeungHyeok Han

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Abstract

Fibroblast growth factor-23 (FGF23) is an established biomarker of adverse outcomes in patients with chronic kidney disease (CKD). Several cross-sectional studies have suggested a possible association between FGF23 and anemia in these patients. In this large-scale prospective cohort study, we investigated this relationship and examined whether high FGF23 levels increase the risk of incident anemia. This prospective longitudinal study included 2,089 patients from the KoreaN cohort study for Outcome in patients With CKD. Anemia was defined as hemoglobin level <13.0 g/dl (men) and <12.0 g/dl (women). Log-transformed FGF23 significantly correlated with hepcidin but inversely correlated with iron profiles and hemoglobin. Multivariate logistic regression showed that log-transformed FGF23 was independently associated with anemia (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.04-1.24, P = 0.01). Among 1,164 patients without anemia at baseline, 295 (25.3%) developed anemia during a median follow-up of 21 months. In fully adjusted multivariable Cox models, the risk of anemia development was significantly higher in the third (hazard ratio [HR], 1.66; 95% CI, 1.11-2.47; P = 0.01) and fourth (HR, 1.84; 95% CI, 1.23-2.76; P = 0.001) than in the first FGF23 quartile. In conclusion, high serum FGF23 levels were associated with an increased risk for anemia in patients with nondialysis CKD.

Original languageEnglish
Article number7294
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - 2018 Dec 1

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Chronic Renal Insufficiency
Anemia
Confidence Intervals
Hemoglobins
Cohort Studies
Prospective Studies
Hepcidins
fibroblast growth factor 23
Proportional Hazards Models
Longitudinal Studies
Iron
Cross-Sectional Studies
Biomarkers
Logistic Models
Odds Ratio
Serum

All Science Journal Classification (ASJC) codes

  • General

Cite this

Nam, Ki Heon ; Kim, Hyoungnae ; An, Seong Yeong ; Lee, Misol ; Cha, Min Uk ; Park, Jung Tak ; Yoo, TaeHyun ; Lee, Kyu Beck ; Kim, Yeong Hoon ; Sung, Su Ah ; Lee, Joongyub ; Kang, Shin-Wook ; Choi, Kyu Hun ; Ahn, Curie ; Han, SeungHyeok. / Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease. In: Scientific Reports. 2018 ; Vol. 8, No. 1.
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title = "Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease",
abstract = "Fibroblast growth factor-23 (FGF23) is an established biomarker of adverse outcomes in patients with chronic kidney disease (CKD). Several cross-sectional studies have suggested a possible association between FGF23 and anemia in these patients. In this large-scale prospective cohort study, we investigated this relationship and examined whether high FGF23 levels increase the risk of incident anemia. This prospective longitudinal study included 2,089 patients from the KoreaN cohort study for Outcome in patients With CKD. Anemia was defined as hemoglobin level <13.0 g/dl (men) and <12.0 g/dl (women). Log-transformed FGF23 significantly correlated with hepcidin but inversely correlated with iron profiles and hemoglobin. Multivariate logistic regression showed that log-transformed FGF23 was independently associated with anemia (odds ratio [OR], 1.14; 95{\%} confidence interval [CI], 1.04-1.24, P = 0.01). Among 1,164 patients without anemia at baseline, 295 (25.3{\%}) developed anemia during a median follow-up of 21 months. In fully adjusted multivariable Cox models, the risk of anemia development was significantly higher in the third (hazard ratio [HR], 1.66; 95{\%} CI, 1.11-2.47; P = 0.01) and fourth (HR, 1.84; 95{\%} CI, 1.23-2.76; P = 0.001) than in the first FGF23 quartile. In conclusion, high serum FGF23 levels were associated with an increased risk for anemia in patients with nondialysis CKD.",
author = "Nam, {Ki Heon} and Hyoungnae Kim and An, {Seong Yeong} and Misol Lee and Cha, {Min Uk} and Park, {Jung Tak} and TaeHyun Yoo and Lee, {Kyu Beck} and Kim, {Yeong Hoon} and Sung, {Su Ah} and Joongyub Lee and Shin-Wook Kang and Choi, {Kyu Hun} and Curie Ahn and SeungHyeok Han",
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Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease. / Nam, Ki Heon; Kim, Hyoungnae; An, Seong Yeong; Lee, Misol; Cha, Min Uk; Park, Jung Tak; Yoo, TaeHyun; Lee, Kyu Beck; Kim, Yeong Hoon; Sung, Su Ah; Lee, Joongyub; Kang, Shin-Wook; Choi, Kyu Hun; Ahn, Curie; Han, SeungHyeok.

In: Scientific Reports, Vol. 8, No. 1, 7294, 01.12.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Circulating Fibroblast Growth Factor-23 Levels are Associated with an Increased Risk of Anemia Development in Patients with Nondialysis Chronic Kidney Disease

AU - Nam, Ki Heon

AU - Kim, Hyoungnae

AU - An, Seong Yeong

AU - Lee, Misol

AU - Cha, Min Uk

AU - Park, Jung Tak

AU - Yoo, TaeHyun

AU - Lee, Kyu Beck

AU - Kim, Yeong Hoon

AU - Sung, Su Ah

AU - Lee, Joongyub

AU - Kang, Shin-Wook

AU - Choi, Kyu Hun

AU - Ahn, Curie

AU - Han, SeungHyeok

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Fibroblast growth factor-23 (FGF23) is an established biomarker of adverse outcomes in patients with chronic kidney disease (CKD). Several cross-sectional studies have suggested a possible association between FGF23 and anemia in these patients. In this large-scale prospective cohort study, we investigated this relationship and examined whether high FGF23 levels increase the risk of incident anemia. This prospective longitudinal study included 2,089 patients from the KoreaN cohort study for Outcome in patients With CKD. Anemia was defined as hemoglobin level <13.0 g/dl (men) and <12.0 g/dl (women). Log-transformed FGF23 significantly correlated with hepcidin but inversely correlated with iron profiles and hemoglobin. Multivariate logistic regression showed that log-transformed FGF23 was independently associated with anemia (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.04-1.24, P = 0.01). Among 1,164 patients without anemia at baseline, 295 (25.3%) developed anemia during a median follow-up of 21 months. In fully adjusted multivariable Cox models, the risk of anemia development was significantly higher in the third (hazard ratio [HR], 1.66; 95% CI, 1.11-2.47; P = 0.01) and fourth (HR, 1.84; 95% CI, 1.23-2.76; P = 0.001) than in the first FGF23 quartile. In conclusion, high serum FGF23 levels were associated with an increased risk for anemia in patients with nondialysis CKD.

AB - Fibroblast growth factor-23 (FGF23) is an established biomarker of adverse outcomes in patients with chronic kidney disease (CKD). Several cross-sectional studies have suggested a possible association between FGF23 and anemia in these patients. In this large-scale prospective cohort study, we investigated this relationship and examined whether high FGF23 levels increase the risk of incident anemia. This prospective longitudinal study included 2,089 patients from the KoreaN cohort study for Outcome in patients With CKD. Anemia was defined as hemoglobin level <13.0 g/dl (men) and <12.0 g/dl (women). Log-transformed FGF23 significantly correlated with hepcidin but inversely correlated with iron profiles and hemoglobin. Multivariate logistic regression showed that log-transformed FGF23 was independently associated with anemia (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.04-1.24, P = 0.01). Among 1,164 patients without anemia at baseline, 295 (25.3%) developed anemia during a median follow-up of 21 months. In fully adjusted multivariable Cox models, the risk of anemia development was significantly higher in the third (hazard ratio [HR], 1.66; 95% CI, 1.11-2.47; P = 0.01) and fourth (HR, 1.84; 95% CI, 1.23-2.76; P = 0.001) than in the first FGF23 quartile. In conclusion, high serum FGF23 levels were associated with an increased risk for anemia in patients with nondialysis CKD.

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