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. 2009 Feb;94(2):511-7.
doi: 10.1210/jc.2008-0326. Epub 2008 Dec 2.

Relationship between plasma fibroblast growth factor-23 concentration and bone mineralization in children with renal failure on peritoneal dialysis

Katherine Wesseling-Perry  1 , Renata C Pereira, Hejing Wang, Robert M Elashoff, Shobha Sahney, Barbara Gales, Harald Jüppner, Isidro B Salusky
Affiliations

Relationship between plasma fibroblast growth factor-23 concentration and bone mineralization in children with renal failure on peritoneal dialysis

Katherine Wesseling-Perry et al. J Clin Endocrinol Metab. 2009 Feb.

Abstract

Context: Fibroblast growth factor (FGF)-23 is produced in bone, and circulating levels are markedly elevated in patients with end-stage kidney disease, but the relationship between plasma levels of FGF-23 and bone histology in dialysis patients with secondary hyperparathyroidism is unknown.

Objective: The aim of the study was to evaluate the correlation between plasma levels of FGF-23 and bone histology in pediatric patients with end-stage kidney disease who display biochemical evidence of secondary hyperparathyroidism.

Design: We performed a cross-sectional analysis of the relationship between plasma FGF-23 levels and bone histomorphometry.

Setting: The study was conducted in a referral center.

Study participants: Participants consisted of forty-nine pediatric patients who were treated with maintenance peritoneal dialysis and who had serum PTH levels (1st generation Nichols assay) greater than 400 pg/ml.

Intervention: There were no interventions.

Main outcome measure: Plasma FGF-23 levels and bone histomorphometry were measured.

Results: No correlation existed between values of PTH and FGF-23. Bone formation rates correlated with PTH (r = 0.44; P < 0.01), but not with FGF-23. Higher FGF-23 concentrations were associated with decreased osteoid thickness (r = -0.49; P < 0.01) and shorter osteoid maturation time (r = -0.48; P < 0.01).

Conclusions: High levels of FGF-23 are associated with improved indices of skeletal mineralization in dialyzed pediatric patients with high turnover renal osteodystrophy. Together with other biomarkers, FGF-23 measurements may indicate skeletal mineralization status in this patient population.

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Figures

Figure 1
Figure 1
Relationship between log[PTH] and log[bone formation rate/tissue volume]. Open circles depict patients with residual renal function; closed circles depict anuric patients. The shaded area represents the normal range for bone formation rate/tissue volume in children with normal kidney function.
Figure 2
Figure 2
Relationship between log[C-terminal FGF-23] and log[bone formation rate/tissue volume]. Open circles depict patients with residual renal function; closed circles depict anuric patients. The shaded area represents the normal range for bone formation rate/tissue volume in children with normal kidney function.
Figure 3
Figure 3
Relationship between log[C-terminal FGF-23] and osteoid thickness (O.Th). Open circles depict patients with residual renal function; closed circles depict anuric patients. The shaded area represents the normal range for osteoid thickness in children with normal kidney function.
Figure 4
Figure 4
Relationship between log[C-terminal FGF-23] and osteoid maturation time (OMT). Open circles depict patients with residual renal function; closed circles depict anuric patients. The shaded area represents the normal range for osteoid maturation time in children with normal kidney function.
See this image and copyright information in PMC

References

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