5 years ago

Association between circulating fibroblast growth factor 21 and mortality in end-stage renal disease

Yoshinobu Kanda, Tetsu Akimoto, Chuji Sekiguchi, Marina Kohara, Makoto Kuro-o, Yasushi Asano, Yasuharu Miyazawa, Sumiko Honma, Eiji Kusano, Yuko Watanabe, Takahiro Masuda, Kazuhiro Shiizaki, Daisuke Nagata

by Marina Kohara, Takahiro Masuda, Kazuhiro Shiizaki, Tetsu Akimoto, Yuko Watanabe, Sumiko Honma, Chuji Sekiguchi, Yasuharu Miyazawa, Eiji Kusano, Yoshinobu Kanda, Yasushi Asano, Makoto Kuro-o, Daisuke Nagata

Fibroblast growth factor 21 (FGF21) is an endocrine factor that regulates glucose and lipid metabolism. Circulating FGF21 predicts cardiovascular events and mortality in type 2 diabetes mellitus, including early-stage chronic kidney disease, but its impact on clinical outcomes in end-stage renal disease (ESRD) patients remains unclear. This study enrolled 90 ESRD patients receiving chronic hemodialysis who were categorized into low- and high-FGF21 groups by the median value. We investigated the association between circulating FGF21 levels and the cardiovascular event and mortality during a median follow-up period of 64 months. A Kaplan-Meier analysis showed that the mortality rate was significantly higher in the high-FGF21 group than in the low-FGF21 group (28.3% vs. 9.1%, log-rank, P = 0.034), while the rate of cardiovascular events did not significantly differ between the two groups (30.4% vs. 22.7%, log-rank, P = 0.312). In multivariable Cox models adjusted a high FGF21 level was an independent predictor of all-cause mortality (hazard ratio: 3.98; 95% confidence interval: 1.39–14.27, P = 0.009). Higher circulating FGF21 levels were associated with a high mortality rate, but not cardiovascular events in patient with ESRD, suggesting that circulating FGF21 levels serve as a predictive marker for mortality in these subjects.

Publisher URL: http://journals.plos.org/plosone/article

DOI: 10.1371/journal.pone.0178971

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