Kidney Week

Abstract: TH-PO470

FGF-23, Hypertension, and Dyslipidemia in Glomerular Disease

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors, Prevention
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

• Sethna, Christine B., Cohen Children's Medical Center of NY, New Hyde Park, New York, United States

Christine B. Sethna,

• Leonard, Mary B., Stanford School of Medicine, Stanford, California, United States

Mary B. Leonard,

• Meyers, Kevin E.C., The Children Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, United States

Kevin E.C. Meyers,

• Brady, Tammy M., Johns Hopkins University , Baltimore, Maryland, United States

Tammy M. Brady,

• Hoofnagle, Andrew N., University of Washington, Seattle, Washington, United States

Andrew N. Hoofnagle,

• Wolf, Myles, Duke University, Durham, North Carolina, United States

Myles Wolf,

• Denburg, Michelle, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States

Michelle Denburg,

Background

Fibroblast growth factor-23 (FGF-23) has direct effects on vasculature and myocardium and is a risk factor for cardiovascular disease (CVD); however, the impact on CVD in glomerular disease (GD) has not been addressed.

Methods

Plasma intact FGF-23, casual blood pressure (BP) and serum lipids were measured cross-sectionally in Nephrotic Syndrome Study Network (NEPTUNE) participants. Multiple regression analyzed the association of FGF-23 with BP and lipids adjusted for age, sex, black race, glomerular diagnosis, estimated glomerular filtration rate (eGFR), urine protein:creatinine (UPC), obesity and phosphorus (+ height in BP models). FGF-23 was divided into tertiles (<100,≥170 pg/ml). Hypertension (HTN) was defined as BP ≥130/80 mmHg for adults and per established definitions in children (Flynn 2017). BP index (BPi) was calculated as BP÷130/80 for adults and 95^th %tile for children. Dyslipidemia (DLP) was defined as abnormal triglycerides, HDL or non-HDL for age (AHA 2013, Daniels 2011).

Results

204 adults (46±16 yr, 60% M, 23% black) and 93 children (9.6±5 yr, 59% M, 42% black) with median eGFR of 78.4 (IQR 50,104.9) ml/min/1.73m² and UPC 1.83 (IQR 0.57,3.8) were evaluated. Diagnoses included membranous 17%, minimal change 24%, FSGS 33% and IgA 14%. Median FGF-23 was 73 (IQR 50,110) pg/ml, PTH 38 (IQR 26,59) pg/ml and phosphorus 3.9 (IQR 3.4,4.4) mg/dl. HTN was present in 68% and DLP in 75%; mean SBPi was 0.83±0.15 and DBPi 0.94±0.18. The highest tertile of FGF-23 was associated with HTN, SBP, DBP, SBPi and DBPi, vs. the lowest tertile in adjusted models (Table 1). FGF-23 was not associated with DLP.

Conclusion

In NEPTUNE, FGF-23 was directly associated with HTN and BP. Further study of FGF-23 as a therapeutic target for reducing CVD in GD is warranted.

Funding

• Other NIH Support