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Kidney Week

Abstract: TH-PO774

Fibroblast Growth Factor 23 and Anemia in Pediatric Renal Transplant Recipients

Session Information

  • Pediatric CKD
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Limm-Chan, Blair N., University of California Los Angeles, Los Angeles, California, United States
  • Wesseling-Perry, Katherine, University of California Los Angeles, Los Angeles, California, United States
  • Pearl, Meghan, University of California Los Angeles, Los Angeles, California, United States
  • Weng, Patricia L., University of California Los Angeles, Los Angeles, California, United States
  • Tsai, Eileen W., University of California Los Angeles, Los Angeles, California, United States
  • Hanudel, Mark R., University of California Los Angeles, Los Angeles, California, United States
Background

Pre-clinical studies have shown that anemia-related factors, specifically iron deficiency and increased erythropoietin (EPO), can induce FGF23 production. Studies of adult renal transplant recipients (RTR) have demonstrated independent associations between both lower iron levels and higher EPO concentrations and increased FGF23. In the present study, we evaluated cross-sectional and longitudinal associations between hematologic and FGF23 parameters in pediatric RTR.

Methods

Demographic, clinical, and standard biochemical data were collected from a cross-section of 59 pediatric RTR during routine clinic visits. Iron, EPO, C-terminal (total) FGF23 (cFGF23), and intact FGF23 (iFGF23) concentrations were measured in additional blood samples. Follow-up biochemical data and blood samples were collected from a subset of 29 patients six months later.

Results

Demographic, clinical, and baseline serum parameters are shown in Table 1. Neither cFGF23 nor iFGF23 was significantly associated with iron or EPO (Table 2). cFGF23 correlated inversely with hemoglobin (r=-0.38, p=0.003), while iFGF23 correlated positively with hemoglobin (r=0.28, p=0.03). The cFGF23-hemoglobin association remained significant after adjusting for eGFR, iron, and EPO. Change in cFGF23 over time tended to inversely correlate with change in hemoglobin (r=-0.34, p=0.07).

Conclusion

In pediatric RTR, differential associations between hemoglobin and cFGF23 vs. iFGF23 are observed, suggesting complex relationships among anemia, FGF23 production, and FGF23 metabolism that warrant further study.

Funding

  • Other NIH Support