ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2020
Serial Fibroblast Growth Factor 23 Measurements and Risk of Requirement for Kidney Replacement Therapy: The CRIC (Chronic Renal Insufficiency Cohort) Study.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 19 citations in OpenAlex.
- Trial
- Fibroblast Growth Factor 23 Trajectories in Children and Association with CKD Progression: The CKD in Children Study.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Fibroblast Growth Factor 23, Urinary Phosphate, and Risk of Progression of CKD.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Pathophysiology of chronic kidney disease-mineral bone disorder (CKD-MBD): from adaptive to maladaptive mineral homeostasis.Clinical kidney journal · 2025Article
- Mineral Bone Disorders in Kidney Disease Patients: The Ever-Current Topic.International journal of molecular sciences · 2022Review
- Effect of Fushengong Decoction on PTEN/PI3K/AKT/NF-κB Pathway in Rats With Chronic Renal Failure via Dual-Dimension Network Pharmacology Strategy.Frontiers in pharmacology · 2022Article
- Clinical Effect of Mudan Granule on Peripheral Neuritis Caused by Chronic Renal Insufficiency.Computational and mathematical methods in medicine · 2022Article
- A Comparative Study of Serum Phosphate and Related Parameters in Chronic Kidney Disease between the USA and Japan.American journal of nephrology · 2022Article
- Iron status, fibroblast growth factor 23 and cardiovascular and kidney outcomes in chronic kidney disease.Kidney international · 2021Article
- The Emerging Role of Innate Immunity in Chronic Kidney Diseases.International journal of molecular sciences · 2020Review
Corrections and comments
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Authors and funding
19 authors at 11 institutions in 1 country.
Funding
Abstract
RATIONALE &
objectiveStudies using a single measurement of fibroblast growth factor 23 (FGF-23) suggest that elevated FGF-23 levels are associated with increased risk for requirement for kidney replacement therapy (KRT) in patients with chronic kidney disease. However, the data do not account for changes in FGF-23 levels as kidney disease progresses. STUDY
designCase-cohort study. SETTING &
participantsTo evaluate the association between serial FGF-23 levels and risk for requiring KRT, our primary analysis included 1,597 individuals in the Chronic Renal Insufficiency Cohort Study who had up to 5 annual measurements of carboxy-terminal FGF-23. There were 1,135 randomly selected individuals, of whom 266 initiated KRT, and 462 individuals who initiated KRT outside the random subcohort. EXPOSURE: Serial FGF-23 measurements and FGF-23 trajectory group membership. OUTCOMES: Incident KRT. ANALYTICAL APPROACH: To handle time-dependent confounding, our primary analysis of time-updated FGF-23 levels used time-varying inverse probability weighting in a discrete time failure model. To compare our results with prior data, we used baseline and time-updated FGF-23 values in weighted Cox regression models. To examine the association of FGF-23 trajectory subgroups with risk for incident KRT, we used weighted Cox models with FGF-23 trajectory groups derived from group-based trajectory modeling as the exposure.
resultsIn our primary analysis, the HR for the KRT outcome per 1 SD increase in the mean of natural log-transformed (ln)FGF-23 in the past was 1.94 (95% CI, 1.51-2.49). In weighted Cox models using baseline and time-updated values, elevated FGF-23 level was associated with increased risk for incident KRT (HRs per 1 SD ln[FGF-23] of 1.18 [95% CI, 1.02-1.37] for baseline and 1.66 [95% CI, 1.49-1.86] for time-updated). Membership in the slowly and rapidly increasing FGF-23 trajectory groups was associated with ∼3- and ∼21-fold higher risk for incident KRT compared to membership in the stable FGF-23 trajectory group. LIMITATIONS: Residual confounding and lack of intact FGF-23 values.
conclusionsIncreasing FGF-23 levels are independently associated with increased risk for incident KRT.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.