Correlation between Fibroblast Growth Factor 23 and C-reactive Protein in Hemodialysis Patients

Fibroblast growth factor 23 (FGF23) levels and inflammatory markers are usually elevated in End-Stage Renal Disease ESRD, and each is associated with adverse clinical outcomes. This study aimed to investigate the hypothesis that FGF23 was independently associated with C-reactive protein in ESRD.

This cross-sectional study was performed on 254 ESRD patients undergoing hemodialysis. The sampling method was census so that all ESRD patients undergoing hemodialysis in the hemodialysis center of Razi Hospital, Rasht, Iran, in 2017, were included in the study. Data analysis was performed using SPSS software (version 26) through the Shapiro-Wilk test, Spearman correlation multiplication, and linear regression.

The median age of the patients was 60 years (age range: 49-69), and 57.9% of the cases were male. The mean and median amount of iFGF23 in patients were 59.5±14.6 and 62 pg/ml (50-70), respectively. Moreover, the median amount of CRP factor was 4 mg/l (1-11). The percentage of positive CRP in the studied patients was 72.9%, while the mean amount and standard deviation in the positive cases were 12.94±8.82. In multiple linear regression analysis, after controlling the effect of confounding variables (individual variables, blood parameters, and underlying diseases), there was a direct and significant relationship between iFGF23 and CRP (P=0.010, 𝜷=0.129, CI=0.032-0.226).

The present study showed that increased FGF23 levels are independently associated with increased CRP levels in patients with ESRD. Future studies should evaluate whether inflammation alters the association between elevated FGF23 levels and adverse clinical outcomes in ESRD.