Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study

Abstract Background Fibroblast growth factor-23 (FGF23) and α-klotho are associated with anemia in patients with chronic kidney disease. In this post hoc analysis of the ASTRIO study (UMIN000019176), we investigated the relationship between FGF23 and α-klotho during treatment with an iron-based phos...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Kyoko Ito, Keitaro Yokoyama, Masaaki Nakayama, Masafumi Fukagawa, Hideki Hirakata
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	ASTRIO study Ferric citrate hydrate FGF23 α-Klotho Hemodialysis iron-based phosphate binder Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/75f8f795c9ba4dac989e29a7b7c58b1c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:75f8f795c9ba4dac989e29a7b7c58b1c
record_format	dspace
spelling	oai:doaj.org-article:75f8f795c9ba4dac989e29a7b7c58b1c2021-11-14T12:43:58ZAssociation of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study10.1186/s12882-021-02575-91471-2369https://doaj.org/article/75f8f795c9ba4dac989e29a7b7c58b1c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12882-021-02575-9https://doaj.org/toc/1471-2369Abstract Background Fibroblast growth factor-23 (FGF23) and α-klotho are associated with anemia in patients with chronic kidney disease. In this post hoc analysis of the ASTRIO study (UMIN000019176), we investigated the relationship between FGF23 and α-klotho during treatment with an iron-based phosphate binder, ferric citrate hydrate (FC), compared with non-iron-based phosphate binders in hemodialysis (HD) patients. We examined the effect of iron absorption by FC on the relationship between FGF23 and α-klotho. There have been few clinical studies evaluating these biomarkers simultaneously in HD patients. Methods The ASTRIO study was a 24-week, randomized, open-label, multicenter trial. HD patients taking non-iron-based phosphate binder(s) were randomized at a 1:1 ratio to continue other binder(s) (control group) or switch to FC (FC group). Serum phosphate (P) and hemoglobin (Hb) were maintained within 3.5–6.0 mg/dL and 10–12 g/dL, respectively. Plasma levels of intact FGF23 (i-FGF23), C-terminal FGF23 (c-FGF23), and α-klotho were measured, as were iron-related parameters. Association analyses of FGF23 and α-klotho were conducted. Results Patients were randomized to FC (n = 48) and control (n = 45) groups. Serum ferritin significantly increased from baseline to end-of-treatment (EOT) in the FC group, compared with the control group (adjusted mean difference [95% confidence interval]: 79.5 [44.7, 114.4] ng/mL; p < 0.001). The mean change from baseline to EOT in c-FGF23 was significantly different between the FC and control groups (mean ± standard deviation (SD): − 0.2 ± 0.8 loge pg/mL vs. 0.2 ± 0.8 loge pg/mL, respectively; p = 0.04). The mean change from baseline to EOT in i-FGF23 and α-klotho were not significantly different between the FC and control groups (mean ± SD: − 0.1 ± 0.8 loge pg/mL vs. 0.1 ± 0.9 loge pg/mL; p = 0.33, and 2.0 ± 91.5 pg/mL vs. − 8.9 ± 145.3; p = 0.58, respectively). However, both forms of FGF23 and α-klotho were not significantly associated with each other in both groups. Conclusions Iron absorbed via FC administration in HD patients did not influence the correlation relationship between plasma levels of FGF23 and α-klotho under the condition of serum P and Hb were maintained. Trial registration ASTRIO study ( UMIN000019176 , registered at UMIN Clinical Trials Registry on October 1, 2015).Kyoko ItoKeitaro YokoyamaMasaaki NakayamaMasafumi FukagawaHideki HirakataBMCarticleASTRIO studyFerric citrate hydrateFGF23α-KlothoHemodialysisiron-based phosphate binderDiseases of the genitourinary system. UrologyRC870-923ENBMC Nephrology, Vol 22, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ASTRIO study Ferric citrate hydrate FGF23 α-Klotho Hemodialysis iron-based phosphate binder Diseases of the genitourinary system. Urology RC870-923
spellingShingle	ASTRIO study Ferric citrate hydrate FGF23 α-Klotho Hemodialysis iron-based phosphate binder Diseases of the genitourinary system. Urology RC870-923 Kyoko Ito Keitaro Yokoyama Masaaki Nakayama Masafumi Fukagawa Hideki Hirakata Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study
description	Abstract Background Fibroblast growth factor-23 (FGF23) and α-klotho are associated with anemia in patients with chronic kidney disease. In this post hoc analysis of the ASTRIO study (UMIN000019176), we investigated the relationship between FGF23 and α-klotho during treatment with an iron-based phosphate binder, ferric citrate hydrate (FC), compared with non-iron-based phosphate binders in hemodialysis (HD) patients. We examined the effect of iron absorption by FC on the relationship between FGF23 and α-klotho. There have been few clinical studies evaluating these biomarkers simultaneously in HD patients. Methods The ASTRIO study was a 24-week, randomized, open-label, multicenter trial. HD patients taking non-iron-based phosphate binder(s) were randomized at a 1:1 ratio to continue other binder(s) (control group) or switch to FC (FC group). Serum phosphate (P) and hemoglobin (Hb) were maintained within 3.5–6.0 mg/dL and 10–12 g/dL, respectively. Plasma levels of intact FGF23 (i-FGF23), C-terminal FGF23 (c-FGF23), and α-klotho were measured, as were iron-related parameters. Association analyses of FGF23 and α-klotho were conducted. Results Patients were randomized to FC (n = 48) and control (n = 45) groups. Serum ferritin significantly increased from baseline to end-of-treatment (EOT) in the FC group, compared with the control group (adjusted mean difference [95% confidence interval]: 79.5 [44.7, 114.4] ng/mL; p < 0.001). The mean change from baseline to EOT in c-FGF23 was significantly different between the FC and control groups (mean ± standard deviation (SD): − 0.2 ± 0.8 loge pg/mL vs. 0.2 ± 0.8 loge pg/mL, respectively; p = 0.04). The mean change from baseline to EOT in i-FGF23 and α-klotho were not significantly different between the FC and control groups (mean ± SD: − 0.1 ± 0.8 loge pg/mL vs. 0.1 ± 0.9 loge pg/mL; p = 0.33, and 2.0 ± 91.5 pg/mL vs. − 8.9 ± 145.3; p = 0.58, respectively). However, both forms of FGF23 and α-klotho were not significantly associated with each other in both groups. Conclusions Iron absorbed via FC administration in HD patients did not influence the correlation relationship between plasma levels of FGF23 and α-klotho under the condition of serum P and Hb were maintained. Trial registration ASTRIO study ( UMIN000019176 , registered at UMIN Clinical Trials Registry on October 1, 2015).
format	article
author	Kyoko Ito Keitaro Yokoyama Masaaki Nakayama Masafumi Fukagawa Hideki Hirakata
author_facet	Kyoko Ito Keitaro Yokoyama Masaaki Nakayama Masafumi Fukagawa Hideki Hirakata
author_sort	Kyoko Ito
title	Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study
title_short	Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study
title_full	Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study
title_fullStr	Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study
title_full_unstemmed	Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study
title_sort	association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of astrio study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/75f8f795c9ba4dac989e29a7b7c58b1c
work_keys_str_mv	AT kyokoito associationoffibroblastgrowthfactor23andaklothoinhemodialysispatientsduringadministrationofferriccitratehydrateposthocanalysisofastriostudy AT keitaroyokoyama associationoffibroblastgrowthfactor23andaklothoinhemodialysispatientsduringadministrationofferriccitratehydrateposthocanalysisofastriostudy AT masaakinakayama associationoffibroblastgrowthfactor23andaklothoinhemodialysispatientsduringadministrationofferriccitratehydrateposthocanalysisofastriostudy AT masafumifukagawa associationoffibroblastgrowthfactor23andaklothoinhemodialysispatientsduringadministrationofferriccitratehydrateposthocanalysisofastriostudy AT hidekihirakata associationoffibroblastgrowthfactor23andaklothoinhemodialysispatientsduringadministrationofferriccitratehydrateposthocanalysisofastriostudy
_version_	1718429056285802496

Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study

Ejemplares similares