MO582LONGITUDINAL STUDY TO FIND THE ASSOCIATION OF SERUM PHOSPHORUS LEVEL WITH FGF 23 IN THREE DIFFERENT HYPERPHOSPHATEMIA MANAGEMENTS GROUPS OF STAGE 3 AND 4 CHRONIC KIDNEY DISEASE (CKD) PATIENTS. (29th May 2021)

• Record Type: Journal Article
• Authors: Kaur, Navjot; Mahapatra, Himansu; Sharma, Neera; Pursnani, Lalit; B, Muthukumar; Inamdar, Neeraj; Singh, Mansi; Arora, Tannu
• Is Part Of: Nephrology dialysis transplantation. Volume 36(2021)Supplement 1
• Publication Date: 2021-05-29
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfab086.0020
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: There were paucity of clinical evidence on target serum phosphorus levelsin early CKD. Present longitudinal study finds target phosphorus level and its association with FGF 23 in three different hyperphosphatemia managements groups. Method: This one year, prospective, randomised controlled, open labelled study was conducted among three equally allocated treatment groups in 120 screened early CKD patients.Group1 Dietary phosphorus modificationn40; Group2 calcium-based phosphate bindersn40 and Group3 non calcium-based phosphate bindersn40.Three monthly dietary assessment, MDRD e-GFR, phosphorus, calcium, iPTH, Alkaline phosphatise and six monthly FGF23, 2D Echocardiography, X ray of chest and abdomen were performed. Association of three categories of phosphorus level up to 3.9 mg/dl, 4 to 5mg/dl and >5mg/dl, rate of progression of all parameters and correlation with FGF 23among all three groups were studied. Results: At baseline, all clinical and biochemical parameters were equally distributed with a controlled nutritional phosphate among all groups. There was no significant difference of FGF23 in all the three categories of phosphorus level among all groups. Association of serum phosphorus at the level of 5 mg/dl was there with iPTH and e-GFR at one year. Over one year there were significant decline in serum phosphorus levels in Group1 p 0.02, Group2 p 0.00, Group3p 0.05;FGF23 was declined significantly only in group3p 0.00.Correlation of FGF23 was positive and negative with iPTH r 0.19, p 0.03 and e-GFR r-0.30, p 0.00respectively but not with phosphorus p0.13 Conclusion: Serum phosphorus levels up to 5mg/dl has no effect on FGF 23 at early CKD stages. Although different treatment groups have significant phosphorus reduction, non-calcium phosphate binder has major impact on FGF23 reduction.