Hormone levels will now tell you whether a kidney patient will die prematurely

In a study appearing in the forthcoming issue of the Journal of the American Society Nephrology (JASN), researchers reveal that the levels of a particular hormone in the blood would enable the prediction of which patients with kidney disease would develop heart problems, might require dialysis, and succumb to premature death. The patients necessitating early treatment can be identified by testing for this hormone, thereby reducing their health risks and prolonging their life span.

Increased blood levels of fibroblast growth factor-23 (FGF-23) analogous to decreased kidney function are observed in patients with chronic kidney disease (CKD). Researchers were unsure whether FGF-23 levels in CKD patients might enable the prediction of developing heart problems (the number one killer of CKD patients), need for dialysis, or premature death.

In order to determine this, Jessica Kendrick, MD, Michel Chonchol, MD (University of Colorado), and their colleagues quantified blood FGF-23 levels of 1,099 advanced CKD patients by grouping them into four quartiles based on their FGF-23 levels.

The patients were followed for an average of 2.9 years. Compared to patients in the group having low FGF-23 levels, those in the group having higher FGF-23 levels developed heart problems, required dialysis, and died. Particularly, if the group with the lowest FGF-23 level was compared with others, fatality risk progressively increased with each subsequent quartile. Considerably high risk of developing heart problems and requiring dialysis were noted in the two highest quartiles.

According to the study findings, determining blood FGF-23 levels might shed light on the development of new therapies in patients with CKD. Dr. Chonchol said, “FGF-23 may be a modifiable risk factor in patients with CKD as it strongly associated with the most important outcomes encountered by these patients: death, cardiovascular events, and initiation of dialysis.”

The determination of whether CKD patients would benefit from treatments to decrease blood FGF-23 levels necessitates further studies.

Study co-authors include Alfred Cheung, MD, Tom Greene, PhD (Veterans Affairs Salt Lake City Healthcare System and University of Utah, Salt Lake City); James Kaufman, MD (Veterans Affairs Boston Healthcare System and Boston University School of Medicine); William Roberts, MD, PhD (University of Utah, Salt Lake City); Gerard Smits, PhD (University of Colorado Denver); and the HOST Investigators.

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