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Evaluation of Intact Fibroblast Growth Factor- 23 (FGF-23) as Predictors of Bone Integrity in Patients with Chronic Kidney Disease

Huseein mohammed kadhim
Medical Laboratory Technique Dept., College of Health & Medical Technique, Southern Technical University, Basrah, Iraq
Dawood S. Mahdi
Medical Laboratory Technique Dept., College of Health & Medical Technique, Southern Technical University, Basrah, Iraq
Hamid Jaddoa Abbas
Al-Faiha’a Teaching Hospital, Al- Zehra ’a Medical College, University of Basra, Basra, Iraq.

Abstract

Back ground:

Chronic kidney disease is an international public health problem affecting 5–10% of the world population. Newly discovered humoral factors- fibroblast growth factor -23 (FGF-23), that are involved in phosphate and vitamin D homeostasis. Elevated levels of the phosphate-regulating hormone fibroblast growth factor- 23 have been linked to greater risk of fractures, especially among individuals with chronic kidney disease (CKD). Therefore, this study was aimed to evaluate FGF23 as a predictor for bone loss and fractures in patients with chronic kidney disease.

Methods:

A case control study; involved (184) participates: 129 patients that meet inclusion criteria and 55 healthy individuals as control group. Serum intact FGF-23 level was measured using an enzyme-linked immunosorbent assay kit. Immune assay (Roche Cobas E411) and spectrophotometry (Roche Cobas C311) techniques were used to analysis other parameters.

Results:

The current study showed significant differences (p< 0.05) in the BMI (26.8), uric acid (4.34), urea (28.18), creatinine (0.76), phosphorus (3.42), calcium (9.12), vitamin D (31.55), albumin (4.30), alkaline phosphatase (74.49), bone specific alkaline phosphatase (1.83), parathyroid hormone (33.51), GFR (88.15) and intact FGF- 23 (133.3) of control group in comparison with BMI (24.1), uric acid (6.53), urea (139.4), creatinine (7.69), phosphorus (6.309), calcium (8.813), vitamin D (15.14), albumin (3.79), alkaline phosphatase (120.2), bone specific alkaline phosphatase (11.85), parathyroid hormone (153.7), GFR (19.47) and intact FGF- 23 (390.1) of CKD patients; respectively. The results of this study were shown no significant differences between CKD patients and healthy control, regarding to ages (P =0.07) and gender (P =0.629). Whereas, showed significant decreases of vitamin D, albumin, calcium levels inpatients, when compared to the control group.

Conclusion:

The current study demonstrated that FGF- 23 was good noninvasive biomarkers for prediction of bone turnover, risk stratification and assessment disease severity in chronic kidney diseases- Metabolic bone disorder.

Keywords: CKD, bone disease, fibroblast growth factor- 23, FGF- 23, vitamin D, bone ALP. ,

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