A Sign of Kidney Failure to Come

Kidney disease patients with high levels of hormone are at risk

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Sometimes, doctors can look for signs in patients to see if they are at risk for complication from a disease further down the road. This lets the doctors help their patients to take steps to avoid that problem.

Now, researchers have found one such sign for kidney failure and death among patients with kidney disease.

Patients with an earlier stage of kidney disease and high levels of a certain hormone - called fibroblast growth factor 23, or FGF23 - have a greater risk of kidney failure and death, compared to those with lower levels of the hormone.

"A certain hormone is a sign of kidney failure and death."

FGF23 is a hormone that controls a person's phosphate levels. The body needs phosphorus to build and heal teeth and bones, to keep cells working, and to maintain DNA. With the help of FGF23, the kidneys control the amount of phosphate in the blood. Kidney disease or damage can raise levels of phosphate, and too much phosphate can make kidney disease worse.

This finding could lead to earlier diagnosis and treatment of patients who have phosphate problems, says Myles Wolf, M.D., M.M.Sc., from the University of of Miami and senior author of the study.

Wolf explains that levels of FGF23 go up before phosphate in people with an earlier stage of kidney disease. Because of this, the hormone could be an early sign that point to patients who need help controlling phosphate levels. If these patients can be spotted, then doctors may be able to maintain kidney function and lower the amount of deaths, Wolf says.

The study - which was supported by the National Center for Research Resources and the National Institute of Diabetes and Digestive Diseases and Kidney Diseases (NIDDK) - involved 3,879 patients with chronic kidney disease.

Looking at patients' information, Wolf and colleagues found that FGF23 is a sign of a higher risk for kidney failure and death. If patients with earlier stage kidney disease have high levels of FGF23 and an estimated glomerular filtration rate (the best test of kidney function) of at least 45 milliliters, then those patients have almost twice the risk of kidney disease, compared to those with lower levels of the hormone. All kidney disease patients with higher levels of FGF23 have three times the risk of death, compared to those with lower levels.

According to Robert A. Star, M.D., from the NIDDK, this hormone could be what allows doctors to see the difference between those who have stable kidney function and those with kidney disease that is getting worse over time. 

Reviewed by: 
Review Date: 
June 15, 2011
Last Updated:
June 16, 2011