https://scholars.lib.ntu.edu.tw/handle/123456789/578404
標題: | Effects of lower versus higher phosphate diets on fibroblast growth factor-23 levels in patients with chronic kidney disease: A systematic review and meta-Analysis | 作者: | Tsai W.-C. Wu H.-Y. Peng Y.-S. Hsu S.-P. Chiu Y.-L. Chen H.-Y. Yang J.-Y. Ko M.-J. Pai M.-F. YU-KANG TU KUAN-YU HUNG KUO-LIONG CHIEN |
公開日期: | 2018 | 出版社: | Oxford University Press | 卷: | 33 | 期: | 11 | 起(迄)頁: | 1977-1983 | 來源出版物: | Nephrology Dialysis Transplantation | 摘要: | Background Elevated fibroblast growth factor-23 (FGF23) levels increase the risk of cardiovascular diseases in patients with chronic kidney disease (CKD). We aimed to compare the effects of different dietary interventions, lower versus higher phosphate levels, on FGF23 in patients with CKD. Methods We conducted electronic literature searches of Medline, PubMed, Embase and the Cochrane Library for publications up to 29 October 2016 for randomized clinical trials that compared lower versus higher phosphate dietary interventions in adults with CKD. The primary outcome was the difference in change-from-baseline FGF23 levels between intervention groups. Considering the difference in measurement units between intact FGF23 and C-Terminal FGF23 assays, the treatment effect was analysed as the standardized mean difference (SMD) with the 95% confidence interval (CI). Results We identified five trials enrolling a total of 94 normophosphataemic patients with Stage 3B CKD. The study duration ranged from 1 to 12 weeks. Compared with higher phosphate diets, lower phosphate diets tended to reduce FGF23 levels (SMD ? '0.74, 95% CI ? '1.54 to 0.07, P = 0.07). Subgroup analyses showed a trend (P for interaction = 0.09) towards a better FGF23-lowering effect by lower phosphate diets in studies using the intact FGF23 assay (SMD ? '1.14, 95% CI ? '2.24 to ? '0.04) than those using the C-Terminal FGF23 assay (SMD ? '0.05, 95% CI ? '0.67 to 0.57). Conclusions Short-Term dietary phosphate restriction tends to reduce FGF23 levels in patients with moderately decreased kidney function, and the FGF23-lowering effects tend to be more prominent when measured with the intact FGF23 assay. ? ? The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85055084542&doi=10.1093%2fndt%2fgfy005&partnerID=40&md5=1747ceac83097ad191c073cbcec084fe https://scholars.lib.ntu.edu.tw/handle/123456789/578404 |
ISSN: | 0931-0509 | DOI: | 10.1093/ndt/gfy005 | SDG/關鍵字: | fibroblast growth factor 23; fibroblast growth factor; fibroblast growth factor 23; phosphate; adverse outcome; Article; carboxy terminal sequence; chronic kidney failure; diet restriction; diet therapy; disease severity; high phosphate diet; human; intermethod comparison; low phosphate diet; meta analysis; phosphate intake; priority journal; randomized controlled trial (topic); short course therapy; systematic review; therapy effect; treatment duration; treatment outcome; cardiovascular disease; chronic kidney failure; complication; diet therapy; metabolism; procedures; Cardiovascular Diseases; Diet Therapy; Fibroblast Growth Factors; Humans; Phosphates; Renal Insufficiency, Chronic |
顯示於: | 醫學系 |
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