Table 2.
Association of FGF23 concentration with all-cause mortality and cardiovascular events in large prospective nondialysis-dependent CKD cohort studies
| Study | Demographics: n; Age (yr); Sex (% Men); Race | Renal Function (CKD; eGFR) | FGF23 Assay/Median Level (IQR) | Outcome | Events (n, %)/Median Follow-Up (yr) | Adjusted Hazard Ratio (95% CI)a | |
|---|---|---|---|---|---|---|---|
| Continuous | Highest Versus Lowest Group | ||||||
| Isakova et al. (CRIC) (4) | 3879; 58±11; 56; 42% African American | 2–4; 43±14 | cFGF23/146 (96–239) | All-cause mortality | 266, 7/3.5 | 1.5 (1.3 to 1.7) per 1 SD included | 3.0 (1.8 to 5.1) |
| Scialla et al. (CRIC) (6) | 3860; 58±11; 56; 42% African American | 2–4; 44±15 | cFGF23/145 (96–239) | Atherosclerotic events; CHF events | 287, 7; 360, 9/3.6 | 1.2 (1.1 to 1.4) per doubling; 1.5 (1.3 to 1.7) per doubling | 1.8 (1.2 to 2.6); 3.0 (2.0 to 4.5) |
| Kendrick et al. (HOST) (5) | 1099; 69±11; 98; 26% African American | 4–5; 18±16 | cFGF23/392 (216–945) | All-cause mortality | 453, 41/2.9 | 1.6 (1.3 to 2.1) per 1 SD included | 2.2 (1.6 to 3.1) |
| Scialla et al. (AASK) (46) | 809; 55±10; 60; 100% African American | 2–5; 45±18 (125I-iothalamate) | iFGF23/44 (31–64) | Composite of all-cause mortality and initiation of RRT | 351, 43 (117, 14 died)/7.9 | 1.3 (1.2 to 1.5) per doubling | 2.3 (1.3 to 3.8) |
| Nakano et al. (OVIDS-CKD) (42) | 738; 64 (54–72); 66; Japanese | 1–5; 35±19 | iFGF23/50 (32–81) | CV events predialysis | 215, 29/4.4 | 1.7 (1.1 to 2.7) per 1 SD included | Not reported |
| Wolf et al. (44) | 984; 55±10; 57; European | Post-transplant;51±21 | cFGF23/28 (20–43) | Composite of all-cause mortality and allograft loss | 182, 18; 87, 9 died/3.1 | 1.4 (1.3 to 1.7) per 1 SD included; 1.5 (1.3 to 1.8) per 1 SD included | 2.2 (1.4 to 3.7); 2.2 (1.1 to 4.0) |
| Baia et al. (45) | 593; 52±12; 54; European (95% white) | Post-transplant;47±16 | cFGF23/140 (95–219) | CV mortality; all-cause mortality | 66, 11; 128, 22/7.0 | 1.9 (1.1 to 3.2) per 1 SD included; 1.9 (1.3 to 2.7) per 1 SD included | 3.0 (1.1 to 8.3); 2.2 (1.1 to 4.5) |
IQR, interquartile range; 95% CI, 95% confidence interval; CRIC, Chronic Renal Insufficiency Cohort; cFGF23, C-terminal FGF23; CHF, congestive heart failure; HOST, Homocysteine in Kidney and End Stage Renal Disease; AASK, African American Study of Kidney Disease and Hypertension; iFGF23, intact FGF23; OVIDS-CKD, Osaka Vitamin D Study in Patients with CKD; CV, cardiovascular.
a
Hazard ratios for fully adjusted models (exact model covariates differ but include adjustment for potential conventional renal, CV, and mineral confounders).