https://scholars.lib.ntu.edu.tw/handle/123456789/532509
標題: | Long-term sevelamer treatment lowers serum fibroblast growth factor 23 accompanied with increasing serum Klotho levels in chronic haemodialysis patients | 作者: | Lin H.-H. Liou H.-H. MING-SHIOU WU Lin C.-Y. Huang C.-C. |
公開日期: | 2014 | 出版社: | Blackwell Publishing | 卷: | 19 | 期: | 11 | 起(迄)頁: | 672-678 | 來源出版物: | Nephrology | 摘要: | Aims: Fibroblast growth factor 23 (FGF23) and Klotho are associated with vascular calcification and cardiovascular disease in dialysis patients. Sevelamer has been shown to reduce progression of vascular calcification. This study aimed to determine the long-term effect of sevelamer treatment on serum FGF23 and Klotho levels in chronic haemodialysis (HD) patients. Methods: In the post-hoc analysis, we measured serum FGF23, Klotho and other biochemical factors (Ca, P, i-PTH, hsCRP, LDL-C) in 50 haemodialysis patients, who completed a 48-week, open-Label, controlled randomized parallel-group study. Twenty-three patients received sevelamer and 27 patients received calcium carbonate. Results: After 48-week sevelamer treatment, there were significant changes with lower LDL-C (from 2.82 ± 0.78 to 1.65 ± 0.53 mmol/L, P = 0.000), lower FGF23 (from 2465.97 (2568.88) to 795.61 (1098.39), P = 0.000) and higher s-Klotho levels (from 189.35 (161.88) to 252.94 (517.80) pg/mL, P = 0.000). In calcium carbonate group, there were no significant changes of LDL-C and FGF23, but with a borderline significant increase of s-Klotho level (from 142.34 (265.24) to 188.57 (252.38) pg/mL, P = 0.054). Multivariate analysis showed that FGF23 decrement was associated with sevelamer treatment (β = -0.277, P = 0.005), change of serum phosphate (β = 0.609, P = 0.000) and calcium levels (β = 0.635, P = 0.000). The increase of serum Klotho was associated with the decrease of serum phosphate (β = 0.490, P = 0.019). Conclusion: Maintenance HD patients had lower serum FGF23 levels, accompanied with significantly increased serum Klotho levels, after 48-week sevelamer treatment. The FGF23 decrement was associated with sevelamer use, the change of serum phosphate and calcium levels. The serum Klotho increment was proportional to the phosphate-lowering power of the binders. ? 2014 Asian Pacific Society of Nephrology. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84907896361&doi=10.1111%2fnep.12319&partnerID=40&md5=c94acf6080ba5095f4f9ed10fbb5030c https://scholars.lib.ntu.edu.tw/handle/123456789/532509 |
ISSN: | 1320-5358 | DOI: | 10.1111/nep.12319 | SDG/關鍵字: | albumin; alkaline phosphatase; C reactive protein; calcium; calcium carbonate; fibroblast growth factor 23; Klotho protein; lipid; low density lipoprotein cholesterol; parathyroid hormone; phosphate; sevelamer; triacylglycerol; beta glucuronidase; calcium carbonate; fibroblast growth factor; fibroblast growth factor 23; Klotho protein; polyamine; sevelamer; adult; alkaline phosphatase blood level; Article; calcium blood level; cardiovascular mortality; comparative study; constipation; controlled study; drug dose titration; drug effect; drug withdrawal; female; gastrointestinal symptom; hemodialysis; hemodialysis patient; human; long term care; maintenance therapy; major clinical study; male; multicenter study (topic); open study; phosphate blood level; pneumonia; post hoc analysis; protein blood level; randomized controlled trial (topic); sepsis; serum fibroblast growth factor 23; serum klotho; stomach cancer; upper abdominal pain; blood; clinical trial; drug effects; middle aged; multicenter study; prospective study; randomized controlled trial; renal replacement therapy; time; Calcium Carbonate; Female; Fibroblast Growth Factors; Glucuronidase; Humans; Male; Middle Aged; Polyamines; Prospective Studies; Renal Dialysis; Time Factors |
顯示於: | 醫學系 |
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