RELATION OF SERUM FIBROBLAST GROWTH FACTOR-23 LEVELS (FGF-23) AND MALNUTRITION IN MAINTENANCE HEMODIALYSIS PATIENTS

Abstract

Chronic kidney disease (CKD) is a major public health problem. There are evidences among community-based studies about CKD as an independent risk factor for malnutrition. In dialysis patients, malnutrition is considered the leading cause of mortality among patients with ESRD. Recently, it was discovered a new agent called FGF23 which help in controlling hyperphosphatemia and in turn nutritional disorders. It was reported that high serum fibroblast growth factor-23 (FGF-23) levels are associated with increased mortality in hemodialysis patients, and can be caused by hyperphosphatemia and loss of residual renal function. However, hypophosphatemia is also associated with increased mortality in maintenance hemodialysis (MHD) patients. This study was performed on 85 stable patients on regular thrice-weekly hemodialysis sessions for at least six months, in Ain Shams Hospital Dialysis Center in Cairo, Egypt. Conducted on April 2015. We studied the relation between serum FGF-23 levels and nutritional status in MHD patients using full history taking, full clinical examination, laboratory investigations including (CBC, S.creatinine, Bl.urea, S.albumin, S.calcium, S.phosphrous, PTH, and intact FGF-23), anthropometeric measurement (weight, height, body mas index, mid-arm circumference, waist cicumference and waist hip ratio), and malnutrition score using modified subjective global assessment. In our study we found that there were a strong inverse relationship between serum FGF-23 levels and malnutrition score, also there were a direct relationship with body mass index (BMI), mid-arm circumference (MAC), and waist to hip ratio (WHR). While there were No significant relation between serum FGF-23 levels and the other parameter. Summary & Conclusion