Table 3.
Relation of FGF23 to CKD disease progression
| Endpoint | Hazard Ratio (95% CI) | ||||
|---|---|---|---|---|---|
| Crude | Adjusted for Baseline eGFRa and MAP | Adjusted for Baseline Albuminuria | Model 1 | Model 2 | |
| A | |||||
| highest FGF23 tertile versus otherb | 12.53 (2.82–55.6) (P<0.001) | 3.95 (0.83–18.70) (P=0.08) | 7.47 (1.60–35.01) (P=0.01) | 5.49 (1.16–25.94) (P=0.03) | 2.21 (0.42–11.57) (P=0.35) |
| log FGF23 as continuous variableb | 11.07 (4.67–26.21) (P<0.001) | 3.70 (1.31–10.41) (P=0.01) | 7.52 (3.22–17.5) (P<0.001) | 4.07 (1.38–12.07) (P=0.01) | 2.72 (0.92–8.07) (P=0.07) |
| log FGF23, using CKD-EPI eGFR equationc | 8.59 (3.92–18.84) (P<0.001) | 3.84 (1.50–9.82) (P=0.005) | 6.13 (2.78–13.42) (P<0.001) | 3.68 (1.37–9.85) (P=0.01) | 3.05 (1.13–8.20) (P=0.03) |
| B | |||||
| highest FGF23 tertile versus otherb | 3.92 (1.94–7.92) (P<0.001) | 2.28 (1.06–4.90) (P=0.03) | 3.02 (1.41–6.50) (P=0.005) | 2.32 (1.09–4.94) (P=0.03) | 1.99 (0.86–4.60) (P=0.11) |
| log FGF23 as continuous variableb | 4.58 (2.66–7.86) (P<0.001) | 2.92 (1.55–5.53) (P<0.001) | 3.90 (2.22– 6.82) (P<0.001) | 2.74 (1.43–5.24) (P=0.002) | 2.94 (1.51–5.74) (P=0.002) |
| log FGF23, using CKD-EPI eGFR equationc | 4.21 (2.52–6.99) (P<0.001) | 2.91 (1.61–5.27) (P<0.001) | 3.62 (2.14–6.12) (P<0.001) | 2.58 (1.40–4.76) (P=0.002) | 2.88 (1.54–5.36) (P<0.001) |
Relation in serum fibroblast growth factor-23 (FGF23) to CKD progression, defined as entering CKD stage 5 or ≥50% reduction in estimated GFR (eGFR; endpoint A) or progression to CKD stage 5 or ≥25% reduction in eGFR over 10 years (endpoint B) in Cox proportional hazards models. FGF23 in the upper tertile as categorical variable and log-transformed FGF23 as continuous variable were adjusted for factors that had been predictive in crude analysis: model 1, factors of mineral metabolism (albumin, phosphate, log parathyroid hormone); model 2, established risk factors for CKD progression (baseline eGFR, baseline albuminuria, and mean arterial BP [MAP]). CI, confidence interval; CKD-EPI, CKD Epidemiology Collaboration.
By 10 ml/min per 1.73 m2.
Using four-measure Modification of Diet in Renal Disease eGFR equation, with 15 patients (8%) reaching endpoint A and 34 patients (19%) reaching endpoint B,
Using CKD Epidemiology Collaboration eGFR equation, which identified 17 patients (9%) as reaching endpoint A and 39 patients (22%) reaching endpoint B.