Abstract: PO1794
Longitudinal Changes in FGF-23 and High-Sensitivity C-Reactive Protein with Incident CKD in the Accord-BP Trial
Session Information
- Hypertension and CVD: Clinical, Outcomes, and Trials
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1402 Hypertension and CVD: Clinical, Outcomes, and Trials
Authors
- Liu, Wenjin, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Huang, Yufeng, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Boucher, Robert E., The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Wei, Guo, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Chertow, Glenn Matthew, Stanford University, Stanford, California, United States
- Beddhu, Srinivasan, The University of Utah School of Medicine, Salt Lake City, Utah, United States
Background
In adults over 50 with increased cardiovascular (CV) risk, intensive systolic blood pressure (SBP) lowering reduces the risk of death and major CV events, but increases the risk of incident CKD. Metabolic manifestations of incident CKD related to intensive SBP lowering are unknown. Here we explored the relation between incident CKD and FGF23, an early marker of bone and mineral metabolism, in participants enrolled in the ACCORD-BP trial.
Methods
We included 362 ACCORD BP participants with incident CKD during follow-up along with 359 control participants without any kidney events. Control participants were matched for age, sex, race/ethnicity, SBP intervention and glycemia intervention arms. Incident CKD was defined as a >30% decrease in eGFR to <60 ml/min/1.73m2. Serum concentrations of FGF23 and hs-CRP were measured using Meso Scale Discovery Immunoassay platform at baseline, month 24 and 48/ close-out. Differences from baseline were estimated for the average of month 24 and 48/ close-out using mixed effect models with fixed effects for group and visit.
Results
Mean age was 63±6 yrs, 55% women, and 30% non-white. Baseline duration of diabetes was 11±8 yrs; baseline eGFR, FGF23 and hsCRP in the incident CKD and control groups were 87±17 and 92±19, 76(55,107) and 52(40,76) pg/ml and 3.2 (1.3,7.2) and 3.8(1.3,12.0) µm/ml, respectively. Longitudinal changes in these parameters are summarized in the Table and Figure.
Conclusion
Compared to controls, incident CKD was associated with increase in serum FGF23 and hsCRP levels. The long-term implications of incident CKD with intensive BP control needs further study.
| Within incident CKD | Within control group | Between groups differences | |
| Geometric mean change from baseline (95% CI) | |||
| FGF23, pg/ml | 1.75 (1.67,1.83) | 0.98 (0.93,1.03) | 1.79 (1.68,1.91) |
| hs-CRP, µm/ml | 0.97 (0.87,1.09) | 0.70 (0.62,0.79) | 1.39 (1.20,1.61) |
| MDRD eGFR | 0.61 (0.60,0.62) | 0.90 (0.89,0.92) | 0.67 (0.66,0.69) |
Funding
- NIDDK Support