Prognostic value and link to atrial fibrillation of soluble Klotho and FGF23 in hemodialysis patients.
Prognostic value and link to atrial fibrillation of soluble Klotho and FGF23 in hemodialysis patients.
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DOI：
10.1371/journal.pone.0100688
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Mueller C
中科院分区：
文献类型：
--
作者：
Nowak A;Friedrich B;Artunc F;Serra AL;Breidthardt T;Twerenbold R;Peter M;Mueller C
钙磷代谢紊乱导致透析患者的发病率和死亡率。本研究旨在评估磷酸尿激素成纤维细胞生长因子23（FGF 23）和可溶性Klotho与全因死亡率的关系。我们测量了239名血液透析患者在入组时和两周后的可溶性Klotho和FGF 23水平。主要假设是低Klotho和高FGF 23与死亡率增加相关。将Klotho与基线时房颤（AF）之间的相关性作为次要结局进行探索。房颤定义为阵发性、持续性或永久性房颤。在中位随访924天期间，59例（25%）患者死于任何原因。在多变量校正分析中，当在连续量表上检查时，（HR 1.25/SD增加，95% CI 0.84-1.86）或三分位数，三分位数1作为参考类别（三分之二的HR为0.65，95% CI 0.26-1.64;三分之三的HR为2.18，95% CI 0.91-2.23）。在多变量逻辑回归分析中，Klotho水平升高与无AF相关（OR 0.66/SD增加，95%CI 0.41-1.00）。在多变量校正分析中，较高的FGF 23水平与死亡风险相关，（HR 1.45/SD增加，95% CI 1.05-1.99）或三分位数，三分位数1作为参考类别（三分之二的HR为1.63，95% CI 0.64-4.14;三分之三的HR为3.91，95% CI 1.28-12.20）。FGF 23而不是Klotho水平与血液透析患者的死亡率相关。Klotho可能对AF有保护作用。
Deranged calcium-phosphate metabolism contributes to the burden of morbidity and mortality in dialysis patients. This study aimed to assess the association of the phosphaturic hormone fibroblast growth factor 23 (FGF23) and soluble Klotho with all-cause mortality. We measured soluble Klotho and FGF23 levels at enrolment and two weeks later in 239 prevalent hemodialysis patients. The primary hypothesis was that low Klotho and high FGF23 are associated with increased mortality. The association between Klotho and atrial fibrillation (AF) at baseline was explored as secondary outcome. AF was defined as presence of paroxysmal, persistent or permanent AF. During a median follow-up of 924 days, 59 (25%) patients died from any cause. Lower Klotho levels were not associated with mortality in a multivariable adjusted analysis when examined either on a continuous scale (HR 1.25 per SD increase, 95% CI 0.84–1.86) or in tertiles, with tertile 1 as the reference category (HR for tertile two 0.65, 95% CI 0.26–1.64; HR for tertile three 2.18, 95% CI 0.91–2.23). Higher Klotho levels were associated with the absence of AF in a muItivariable logistic regression analysis (OR 0.66 per SD increase, 95% CI 0.41–1.00). Higher FGF23 levels were associated with mortality risk in a multivariable adjusted analysis when examined either on a continuous scale (HR 1.45 per SD increase, 95% CI 1.05–1.99) or in tertiles, with the tertile 1 as the reference category (HR for tertile two 1.63, 95% CI 0.64–4.14; HR for tertile three 3.91, 95% CI 1.28–12.20). FGF23 but not Klotho levels are associated with mortality in hemodialysis patients. Klotho may be protective against AF.
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影响因子：
3.7
作者：
Kitagawa M;Sugiyama H;Morinaga H;Inoue T;Takiue K;Ogawa A;Yamanari T;Kikumoto Y;Uchida HA;Kitamura S;Maeshima Y;Nakamura K;Ito H;Makino H
通讯作者：
Makino H
DOI：
10.1056/nejmoa0706130
发表时间：
2008-08-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gutiérrez OM;Mannstadt M;Isakova T;Rauh-Hain JA;Tamez H;Shah A;Smith K;Lee H;Thadhani R;Jüppner H;Wolf M
通讯作者：
Wolf M
影响因子：
6.1
作者：
Komaba, Hirotaka;Koizumi, Masahiro;Fukagawa, Masafumi
通讯作者：
Fukagawa, Masafumi
影响因子：
2.8
作者：
Artunc, Ferruh;Mueller, Christian;Friedrich, Bjoern
通讯作者：
Friedrich, Bjoern
影响因子：
6.2
作者：
Moe, Sharon M.;Radcliffe, J. Scott;Chen, Neal X.
通讯作者：
Chen, Neal X.