Clearance of FGF-23 during continuous renal replacement therapy

FGF-23 is a 32 kDa protein that is a key regulator of phosphorus and vitamin D metabolism. Emerging evidence also demonstrates that FGF-23 increases within 24 hours of acute kidney injury (AKI) and may be associated with adverse clinical outcomes. We conducted this study to evaluate FGF23 clearance during continuous veno-venous hemofiltration (CVVH) in critically ill patients with AKI. We demonstrate that plasma clearance of FGF-23 during CVVH is similar to 11 mL/min and the mean sieving coefficient is 0.27 +/- 0.1. Future studies will need to clarify FGF-23's role in adverse outcomes among AKI patients, and whether therapies aimed at reducing FGF-23 levels may be beneficial.