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Pediatric Nephrology

, Volume 27, Issue 11, pp 2129–2136 | Cite as

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

  • Wacharee Seeherunvong
  • Carolyn L. Abitbol
  • Jayanthi Chandar
  • Paolo Rusconi
  • Gaston E. Zilleruelo
  • Michael FreundlichEmail author
Original Article

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.

Keywords

FGF-23 Mineral disorder Cardiovascular disease Hemodialysis Cardiac hypertrophy 

Notes

Acknowledgments

This work was supported in part by a grant from the Children’s Medical Services of the State of Florida. We thank Dr. Myles Wolf (University of Miami) for constructive discussions and valuable suggestions for the statistical analysis. The expertise and patient care shown by the nursing staff of the Pediatric Dialysis Unit at Holtz Children’s Hospital are greatly appreciated.

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Copyright information

© IPNA 2012

Authors and Affiliations

  • Wacharee Seeherunvong
    • 1
  • Carolyn L. Abitbol
    • 1
  • Jayanthi Chandar
    • 1
  • Paolo Rusconi
    • 2
  • Gaston E. Zilleruelo
    • 1
  • Michael Freundlich
    • 3
    Email author
  1. 1.Division of Pediatric NephrologyUniversity of Miami Miller School of Medicine and Holtz Children’s Hospital/Jackson Memorial Medical CenterMiamiUSA
  2. 2.Division of Pediatric CardiologyUniversity of Miami Miller School of Medicine and Holtz Children’s Hospital/Jackson Memorial Medical CenterMiamiUSA
  3. 3.Division of Pediatric NephrologyUniversity of Miami Miller School of MedicineMiamiUSA

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