FIBROBLAST GROWTH FACTOR 23 IN RENAL ALLOGRAFT RECEPIENTS

AIM: to estimate level of fibroblast growth factor 23 (FGF23) in renal allograft recipients and to evaluate interaction between FGF23 level and some clinical laboratory factors in early and long date after cadaver renal allografting (CRA). PATIENTS AND METHODS. Research included 46 renal allograft recipients, where 21 patient’s postoperative period was less than 24 months on the research period (group 1) and 26 patients with postoperative period more than 24 months (group 2). All patients were performed laboratory research complex, renal allograft ultrasound, serum FGF23 level detection by enzyme-linked immunoelectrodiffusion essay. RESULTS. In group 1 revealed statistically significant correlations between serum FGF23 level and clinical laboratory factors. FGF23 level directly correlate with age of patients (r=0,472; P=0,031), renal replacement therapy (RRT) duration before CRA (r=0,474; P=0,030), systolic blood pressure (BPs) level (r=0,482; P=0,027), erythrocyte sedimentation rate (ESR) (r=0,753; P<0,0001), creatinine (r=0,523; P=0,015), urea (r=0,483; P=0,026), sodium (r=0,634; P=0,002), uric acid (r=0,712; P<0,0001), triglycerides (r=0,476; P=0,029), glucose (r=0494; P=0,023), serum alkaline phosphatase (r=0,506; P=0,019) and proteinuria (r=0,615; P=0,003). High levels of FGF23 were noticed in patients with lower GFR values (r=-0,493; P=0,023). FGF23 feedback with phosphor level was noticed (r=-0,439; P=0,046). In second group FGF23 authentically increased in proportion to allograft function deterioration: direct correlation with serum creatinine (r=0,430; P=0,031) and invert correlation with GFR (r=-0,542, P=0,005). Proteinuria augmentation was involved with high level of FGF23 (r=0,637, P=0,001). In second group serum phosphor directly correlated with FGF23 (r=0,413, P=0,04) (fig. 2). CONCLUSION. In early periods after CRA noticed FGF23 level decreasing in proportion to phospho-calcium homeostasis factors normalization, when in the following in proportion to nephropathy progression in transplant, phospho-calcium metabolic imbalances increase, leading to increased FGF23 synthesis. Maybe in future FGF23 will become new therapeutic target for results improvement in postoperative period.

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