FGF-23, Inflammation and Iron Metabolism in The Early Stages of Autosomal Dominant Polycystic Kidney Disease

To investigate the correlation of Fibroblast Growth Fakt？r-23 (sFGF-23) with iron status, inflammation and carotid intima-media thickness (CIMT) in the early stages of autosomal dominant polycystic kidney disease (ADPKD). Forty ADPKD patients (24 female) with normal creatinine levels and 40 healthy volunteers (21 female) were included in the study. Serum FGF-23 levels were measured using the ELISA technique. The associations between sFGF-23 with CIMT, hs-CRP, neutrophil lymphocyte ratio (NLR) and iron parameters were evaluated using correlation analysis. Patients’ sFGF-23 levels were significantly higher [245 (182-963) pg/mL; vs. 219.6 (34-494) pg/mL], (P< 0.001). NLR and hs-CRP were also found to be statistically higher in patients than controls (P< 0.001 and P= 0.003, respectively). CIMT was significantly higher in the patient group (P= 0.037). There were statistically significant negative correlations between sFGF-23 and calcium, hemoglobin, hematocrit, serum iron, ferritin, and NLR (P= 0.009, P= 0.035, P= 0.002, P= 0.033, P= 0.017, P= 0.023, respectively), and positive correlations with phosporus, total iron binding capacity and sFGF-23 (P= 0.010, P= 0.049, respectively). There was no statistically significant correlation between sFGF-23 and PTH, hs-CRP and CIMT. In multivariate lineer regression analysis, serum phosphorus level was statistically significiant independent risk factor for the determinantion of sFGF-23 level [B: 0.318, OR:130,662(32,715-228,610), P=0.010]. Our study results support an inverse relationship between sFGF-23 and iron deficiency but no relationship between sFGF-23 and inflammation and atherosclerosis in the early stages of ADPKD