FGF-23 removal is improved by on-line high-efficiency hemodiafiltration compared to conventional high flux hemodialysis

J Nephrol. 2013 Mar-Apr;26(2):342-9. doi: 10.5301/jn.5000150. Epub 2012 Apr 27.

Abstract

Background: Reducing circulating levels of fibroblast growth factor-23 (FGF-23) in patients on renal replacement therapy (RRT) could appear as an appealing approach for cardiovascular events prevention. The purpose of our study was to compare the clearance of FGF-23 between high flux hemodialysis (HD) and on-line hemodiafiltration (OL-HDF) procedures.

Methods: Fifty-three patients were included in the HD group while 32 patients were included in the OL-HDF group. Serum pre- and post-dialysis FGF-23 levels were measured using a 2nd generation Human FGF-23 (C-Term) ELISA kit.

Results: Mean FGF-23 reduction rates were significantly higher in OL-HDF (55.7 ± 25.2%) versus HD (36.2 ± 28.6%) groups (P=.0001), as were calculated FGF-23 clearances (P=.015) and Kt/V-FGF-23 (P=.001). Overall, post-treatment FGF-23 levels were significantly lower than pre-treatment values in both groups (P<.01).

Conclusions: OL-HDF achieves higher FGF-23 removal over high flux HD.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Down-Regulation
  • Enzyme-Linked Immunosorbent Assay
  • Equipment Design
  • Female
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / blood*
  • Hemodiafiltration / methods*
  • Humans
  • Linear Models
  • Male
  • Membranes, Artificial
  • Middle Aged
  • Polymers
  • Prospective Studies
  • Renal Dialysis / instrumentation
  • Renal Dialysis / methods*
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / therapy*
  • Sulfones
  • Time Factors
  • Treatment Outcome

Substances

  • FGF23 protein, human
  • Membranes, Artificial
  • Polymers
  • Sulfones
  • polyether sulfone
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23