The correlation between serum fibroblast growth factor-23 levels and left ventricular hypertrophy in chronic kidney disease patients

Introduction: Hyperphosphatemia in chronic kidney disease (CKD) patients can stimulate the production of the fibroblast growth factor-23 (FGF-23) phosphatonin hormone, which is associated with cardiac remodeling resulting in left ventricular hypertrophy (LVH). Objectives: To determine the correlation between FGF-23 level and LVH incidence in CKD patients and establish the associated risk factors. Materials and Methods: This cross-sectional study involved 74 CKD patients who were classified as stage 3 (n=18), stage 4 (n=17), stage 3 (n=18), dialysis stage 5 (n=20), or nondialysis stage 5 (n=19). The FGF-23 levels of the patients were measured using the ELISA (enzyme-linked immunosorbent assay) kit method, whereas a cardiologist verified LVH using an echocardiographic examination based on the LVH criteria of >95 g/m(2) for females and >115 g/m(2) for males. Results: A significant difference was observed in the mean FGF-23 values between the LVH and non-LVH patients (443.27 +/- 437.047 RU/mL and 172.68 +/- 185.56 RU/mL, respectively; P < 0.05). The receiver operating characteristics revealed that patients with FGF-23 levels >123.95 RU/mL had a 3.6 times greater risk of LVH compared to those with values <_123.95 RU/mL. The LVH risk factors of gender and age, as well as hypertension, diabetes mellitus, and obesity diagnoses were not associated with LVH incidence in CKD patients. Conclusion: A significant association was found between FGF-23 level and LVH incidence in CKD patients, in which an FGF-23 level >123.95 RU/mL corresponded to a 3.6 times greater risk of LVH than those with FGF-23 levels below this value.