Researchers Find Independence of Two Risk Factors for Death in Chronic Kidney Disease

Researchers from the University of Miami Miller School of Medicine participated in a multicenter study demonstrating that inflammation and elevated levels of fibroblast growth factor 23 (FGF23), an endocrine hormone, are independent risk factors for death in chronic kidney disease.

“Chronic kidney disease is a public health epidemic that increases risk of death, but the underlying mechanisms are not clearly understood,” said Jair Munoz Mendoza, associate professor of clinical medicine, who was first author of the study report published in the March issue of the journal Kidney International. “Prior studies had suggested that elevated FGF23 and its consequences could be an additional novel mechanism of mortality associated with inflammation.”

Based on those prior studies, the researchers in the Chronic Renal Insufficiency Cohort study, which examined individuals who had moderate CKD at enrollment, expected to find that inflammation and FGF23 had overlapping effects. Instead, they found the two factors were independently associated with increased risk of death.

“Our findings suggest that elevated levels of inflammatory markers and FGF23 increased risk of mortality mostly through seemingly distinct pathways, despite their regulatory effects on one another,” said Munoz Mendoza.

Future studies, he said, should investigate the impact of FGF23-lowering interventions on inflammatory markers, the impact of anti-inflammatory therapies on FGF23 levels, and the potential additive effects of combining such therapeutic strategies to improve clinical outcomes in CKD.

Other Miller School researchers participating in the study were Christian Faul, Ph.D., research associate professor of medicine and cell biology, and Liz Y. Bayes Santos, M.D., assistant professor of pediatrics.

The research was supported by minority supplement grant R01DK081374-S1.

Miller School of Medicine

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