Effect of high-flux dialysis on circulating FGF-23 levels in end-stage renal disease patients

• Verfasst von: Schneider, Andreas [VerfasserIn]
• Verfasst von: Genser, Bernd [VerfasserIn]
• Titel: Effect of high-flux dialysis on circulating FGF-23 levels in end-stage renal disease patients
• Titelzusatz: results from a randomized trial
• Verf.angabe: Andreas Schneider, Markus P. Schneider, Detlef H. Krieter, Bernd Genser, Hubert Scharnagl, Tatjana Stojakovic, Christoph Wanner, Christiane Drechsler
• E-Jahr: 2015
• Jahr: May 29, 2015
• Umfang: 10 S.
• Fussnoten: Gesehen am 20.07.2017
• Titel Quelle: Enthalten in: PLOS ONE
• Ort Quelle: San Francisco, California, US : PLOS, 2006
• Jahr Quelle: 2015
• Band/Heft Quelle: 10(2015,5) Artikel-Nummer e0128079, 10 Seiten
• ISSN Quelle: 1932-6203
• DOI: doi:10.1371/journal.pone.0128079
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Chronic kidney disease
• Sach-SW: Coronary heart disease
• Sach-SW: C-reactive proteins
• Sach-SW: Fibroblast growth factor
• Sach-SW: Kidneys
• Sach-SW: Medical dialysis
• Sach-SW: Membrane dialysis
• Sach-SW: Phosphates
• K10plus-PPN: 1561069302

Abstract

Background In patients undergoing maintenance hemodialysis (HD), increased levels of circulating fibroblast growth factor-23 (FGF-23) are independently associated with cardiovascular events and mortality. Interventional strategies aiming to reduce levels of FGF-23 in HD patients are of particular interest. The purpose of the current study was to compare the impact of high-flux versus low-flux HD on circulating FGF-23 levels. Methods We conducted a post-hoc analysis of the MINOXIS study, including 127 dialysis patients randomized to low-flux (n = 62) and high-flux (n = 65) HD for 52 weeks. Patients with valid measures for FGF-23 investigated baseline and after 52 weeks were included. Results Compared to baseline, a significant increase in FGF-23 levels after one year of low-flux HD was observed (Delta plasma FGF-23: +4026 RU/ml; p < 0.001). In contrast, FGF-23 levels remained stable in the high flux group (Delta plasma FGF-23: +373 RU/ml, p = 0.70). The adjusted difference of the absolute change in FGF-23 levels between the two treatment groups was statistically significant (p < 0.01). Conclusions Over a period of 12 months, high-flux HD was associated with stable FGF-23 levels, whereas the low-flux HD group showed an increase of FGF-23. However, the implications of the different FGF 23 time-trends in patients on high flux dialysis, as compared to the control group, remain to be explored in specifically designed clinical trials. Trial Registration German Clinical Trials Register (DRKS) DRKS00007612.