• Heng Jung Hsu and Mai-Szu Wu.
• School of Medicine, Chang Gung University, and Department of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.
• Am. J. Med. Sci. 2009 Feb 1; 337 (2): 116-22.

BackgroundLeft ventricular hypertrophy (LVH) is a common cardiovascular disorder and an independent risk factor for cardiovascular death in dialysis patients. Hyperphosphatemia is associated with LVH. Previous studies have shown that fibroblast growth factor 23 (FGF23), which has an important role in phosphate metabolism, is elevated in chronic hemodialysis patients.ObjectivesThe aim of this study is to determine the association of FGF23 and LVH and the prognostic value of FGF23 in chronic hemodialysis patients.Materials And MethodsOne hundred twenty-four end-stage renal disease patients were evaluated for LVH by echocardiography. Serum FGF23 levels were measured using a commercial enzyme-linked immunosorbent assay kit.ResultsPatients with LVH were more likely to have poor urea clearance (Kt/V), higher systolic blood pressure, and comorbidity of diabetes mellitus and coronary artery disease. LVH was also associated with higher levels of FGF23. Multivariate analysis indicated that FGF23 level, systolic blood pressure, and comorbidity of diabetes mellitus and coronary artery disease remained correlated with LVH. This suggested that serum FGF23 level is independently associated with LVH in our hemodialysis patients. Cox analysis indicated no significant difference in risk of death for patients with elevated levels of FGF23.ConclusionLVH has a high prevalence in hemodialysis patients, and FGF23 is independently associated with LVH but is not a predictor for short-term prognosis (2-year follow-up).

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