FGF-23 (Fibroblast Growth Factor-23) and Cardiorenal Interactions.
chloride
diuretic
heart failure
models, animal
outpatient
Journal
Circulation. Heart failure
ISSN: 1941-3297
Titre abrégé: Circ Heart Fail
Pays: United States
ID NLM: 101479941
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
pubmed:
26
10
2021
medline:
22
12
2021
entrez:
25
10
2021
Statut:
ppublish
Résumé
Animal models implicate FGF-23 (fibroblast growth factor-23) as a direct contributor to adverse cardiorenal interactions such as sodium avidity, diuretic resistance, and neurohormonal activation, but this has not been conclusively demonstrated in humans. Therefore, we aimed to evaluate whether FGF-23 is associated with parameters of cardiorenal dysfunction in humans with heart failure, independent of confounding factors. One hundred ninety-nine outpatients with heart failure undergoing diuretic treatment at the Yale Transitional Care Center were enrolled and underwent blood collection, and urine sampling before and after diuretics. FGF-23 was associated with several metrics of disease severity such as higher home loop diuretic dose and NT-proBNP (N-terminal pro-B-type natriuretic peptide), and lower estimated glomerular filtration rate, serum chloride, and serum albumin. Multivariable analysis demonstrated no statistically significant association between FGF-23 and sodium avidity measured by fractional excretion of sodium, or proximal or distal tubular sodium reabsorption, either before diuretic administration or at peak diuresis ( FGF-23 was not meaningfully associated with any cardiorenal parameter in patients with heart failure. While our methods cannot rule out a small effect, FGF-23 is unlikely to be a primary driver of cardiorenal interactions.
Sections du résumé
BACKGROUND
Animal models implicate FGF-23 (fibroblast growth factor-23) as a direct contributor to adverse cardiorenal interactions such as sodium avidity, diuretic resistance, and neurohormonal activation, but this has not been conclusively demonstrated in humans. Therefore, we aimed to evaluate whether FGF-23 is associated with parameters of cardiorenal dysfunction in humans with heart failure, independent of confounding factors.
METHODS
One hundred ninety-nine outpatients with heart failure undergoing diuretic treatment at the Yale Transitional Care Center were enrolled and underwent blood collection, and urine sampling before and after diuretics.
RESULTS
FGF-23 was associated with several metrics of disease severity such as higher home loop diuretic dose and NT-proBNP (N-terminal pro-B-type natriuretic peptide), and lower estimated glomerular filtration rate, serum chloride, and serum albumin. Multivariable analysis demonstrated no statistically significant association between FGF-23 and sodium avidity measured by fractional excretion of sodium, or proximal or distal tubular sodium reabsorption, either before diuretic administration or at peak diuresis (
CONCLUSIONS
FGF-23 was not meaningfully associated with any cardiorenal parameter in patients with heart failure. While our methods cannot rule out a small effect, FGF-23 is unlikely to be a primary driver of cardiorenal interactions.
Identifiants
pubmed: 34689571
doi: 10.1161/CIRCHEARTFAILURE.121.008385
pmc: PMC8782627
mid: NIHMS1743924
doi:
Substances chimiques
Diuretics
0
Sodium Potassium Chloride Symporter Inhibitors
0
Fibroblast Growth Factor-23
7Q7P4S7RRE
Sodium
9NEZ333N27
Renin
EC 3.4.23.15
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e008385Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL128973
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK130870
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL139629
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL148354
Pays : United States
Organisme : NHLBI NIH HHS
ID : L30 HL115790
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL114868
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK007219
Pays : United States
Organisme : NHLBI NIH HHS
ID : R21 HL143092
Pays : United States
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