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Pediatric Nephrology
Published in: Pediatric Nephrology 11/2012

01-11-2012 | Original Article

Fibroblast growth factor 23 and left ventricular hypertrophy in children on dialysis

Authors: Wacharee Seeherunvong, Carolyn L. Abitbol, Jayanthi Chandar, Paolo Rusconi, Gaston E. Zilleruelo, Michael Freundlich

Published in: Pediatric Nephrology | Issue 11/2012

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Abstract

Background

Elevated fibroblast growth factor 23 (FGF-23) concentrations associate with left ventricular hypertrophy (LVH) and adverse outcomes in adult patients with chronic kidney disease. We hypothesized that similar associations are present in pediatric patients on maintenance hemodialysis.

Methods

In this retrospective study of 26 young patients on chronic hemodialysis, aged 6–21 years, cardiac structure and geometry were measured by echocardiography, and circulating levels of FGF-23 and calciotropic hormones were obtained.

Results

FGF-23 levels were uniformly elevated in all patients from three- to 835-fold above the upper limit of normal. The average LV mass index (LVMI) was 43 ± 13 g/m2.7 and reflected LVH in 55 % of patients. Log-transformed FGF-23 concentrations correlated with LVMI (p = 0.03) and were independently associated with the interventricular septal thickness Z-score (p < 0.001). Concentric LVH was associated with the highest FGF-23 concentrations and the highest LVMI measurements (p < 0.001). Each 1 standard deviation increase in log-transformed FGF-23 levels was associated with a 17 % increase in LVMI.

Conclusions

FGF-23 levels are strongly associated with increased LVMI and with prevalent LVH in pediatric hemodialysis patients. Our cross-sectional findings provide observational evidence supporting the hypothesis linking FGF-23 to cardiac hypertrophy in patients with chronic kidney disease.
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Metadata
Title
Fibroblast growth factor 23 and left ventricular hypertrophy in children on dialysis
Authors
Wacharee Seeherunvong
Carolyn L. Abitbol
Jayanthi Chandar
Paolo Rusconi
Gaston E. Zilleruelo
Michael Freundlich
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Pediatric Nephrology / Issue 11/2012
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-012-2224-7

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