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(Ivanhoe Newswire) -- Monitoring a hormone level in dialysis patients could help doctors determine which patients with kidney failure are at risk for death. A new study focuses on fibroblast growth factor 23 (FGF-23). Researchers say they found patients with elevated levels of FGF-23 at the start of dialysis had a significantly increased risk of death within the first year of treatment.
FGF-23 helps regulate serum phosphate levels and doctors say they know elevated phosphate is associated with a faster progression of kidney failure and death. For this research, investigators from Massachusetts General Hospital started with data on more than 10,000 patients at 1,000 centers in North America. They examined the relationship between phosphate levels and the risk of death within the year of starting dialysis. They found the death rate was modestly higher in those with a higher phosphate level.
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Researchers then compared FGF-23 levels of 200 patients who died during the first year to 200 patients who survived. They found elevated FGF-23 was a much more powerful predictor of death than serum phosphate measured at the same time. Study authors say the mortality rate was 600 percent higher in those with the highest FGF-23 rates compared to those with the lowest.
Interestingly, researchers found FGF-23 levels tended to be lower among black and Hispanic patients, which could explain a better mortality rate among these racial groups. Study authors conclude incorporating FGF-23 levels into the management of kidney failure could have great potential for the treatment of millions of people with early-stage kidney disease.
SOURCE: New England Journal of Medicine, 2008
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