Abstract: FR-PO0056
Diagnostic and Prognostic Value of Fibroblast Growth Factor 23 (FGF-23) in Critically Ill Patients with AKI
Session Information
- AKI: Epidemiology, Risk Factors, and Prevention
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Shao, Fengmin, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Gu, Yue, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Yan, Baolan, Henan Provincial People's Hospital, Zhengzhou, Henan, China
Background
To evaluate serum FGF23 as a diagnostic and prognostic biomarker in AKI among critically ill patients.
Methods
This prospective cohort included 190 ICU patients,stratified into AKI (n=100) and non-AKI (n=90) groups per KDIGO criteria within 7 days of admission. The AKI group was further subclassified by renal recovery status at discharge. Serum iFGF23 and cFGF23 levels were measured within 24 hours of ICU admission, along with baseline clinical biomarkers. Univariate and multivariate logistic regression identified AKI risk factors. FGF23's predictive performance was assessed via ROC analysis.
Results
No intergroup differences were observed in demographic characteristics or baseline comorbidities (all P>0.05). AKI patients demonstrated significantly higher serum creatinine, neutrophil percentage, and phosphate levels alongside lower eGFR, albumin, and calcium levels (P<0.05). Serum cFGF23 was substantially elevated in AKI patients (69.90 [30.68–228.12] vs 33.85 [23.02-66.43] RU/mL, P<0.001), with no difference in iFGF23 levels (P=0.653). The cFGF23/iFGF23 ratio was significantly increased in AKI (4.77 [2.14-13.88] vs 2.41 [1.36-3.46], P<0.001). Multivariate analysis confirmed hypocalcemia and elevated cFGF23 as independent AKI predictors. ROC analysis revealed cFGF23's diagnostic utility (AUC 0.72, sensitivity 60.6%, specificity 72.2%), which improved to 85.6% specificity when combined with creatinine.
Conclusion
Serum cFGF23 independently predicts AKI and complements creatinine-based diagnosis. Their combination enhances diagnostic specificity, offering clinical utility for early AKI detection in critical care.