Abstract: TH-PO053
Fibroblast Growth Factor 23, a Novel Biomarker for AKI in Patients with Acute Decompensated Heart Failure
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - I
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Pramong, Nattha, Bhumibol Adulyadej hospital, Bangkok, Thailand
- Gojaseni, Pongsathorn, Bhumibol Adulyadej hospital, Bangkok, Thailand
- Suttipongkeat, Sarunyoo, Bhumibol Adulyadej hospital, Bangkok, Thailand
- Kiattisunthorn, Kraiwiporn, Siriraj Medical School, Mahidol University, Bangkok-noi, Thailand
- Chittinandana, Anutra, Bhumibol Adulyadej hospital, Bangkok, Thailand
Background
Acute kidney injury (AKI) in acute decompensated heart failure (ADHF) is associated with poor prognosis. Recent evidences have proved that early rising of plasma Fibroblast Growth Factor 23 (FGF23) can predict AKI and adverse events in patients undergoing cardiac surgery and critically ill patients, but it remains unknown in ADHF patients. This study aimed to investigate the prognostic value of plasma FGF23 for predicting the occurrence of AKI.
Methods
A single center cohort study is performed in patients admitted for ADHF in Bhumibol Adulyadej hospital. Plasma c-terminal FGF23 (c-FGF23) was measured 2 times at baseline and 24 hours later after diagnosing ADHF. Serum creatinine was measured every other day or more frequently as appropriate according to general treating standards and AKI was assessed and defined using KDIGO criteria.
Results
The study enrolled 62 patients diagnosed with ADHF. The incidence of AKI is 45% and significantly increased risk of death. Patients who developed AKI had significantly higher levels of plasma c-FGF23 at baseline in comparison with AKI-free patients (median value 1,258.5 Ru/mL vs. 230.2 Ru/ml, p = 0.005). During the first 24 hours, plasma c-FGF23 levels in AKI-free group decreased more than AKI group, but the difference is not statistically significant. ROC analysis of both first time and second time of plasma c-FGF23 collecting yielded an AUC of 0.71 for prediction of AKI incident. With the cut-off point at 450 RU/ml, the sensitivity and specificity of plasma c-FGF23 at baseline for predicting AKI were 71.4% and 61.8% respectively.
Conclusion
Plasma c-FGF23 may serve as a novel biomarker for incident of AKI in patients with acute decompensated heart failure which should be measured immediately or within 24 hours after diagnosing ADHF.
Funding
- Government Support - Non-U.S.