ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2022 and some content may be unavailable. To unlock all content for 2022, please visit the archives.

Abstract: FR-PO792

High Pretransplant FGF-23 Level Is Associated With Poor Graft Survival and Persistent Vitamin D Insufficiency in Kidney Transplant Patients

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Ryu, Jung-hwa, Ewha Womans University Seoul Hospital, Seoul, Korea (the Republic of)
  • Koo, Tai yeon, Korea University, Seongbuk-gu, Seoul , Korea (the Republic of)
  • Kim, Hyo Jeong, Yonsei University College of Medicine, Seodaemun-gu, Seoul , Korea (the Republic of)
  • Heo, Ga Young, Yonsei University College of Medicine, Seodaemun-gu, Seoul , Korea (the Republic of)
  • Yang, Jaeseok, Yonsei University College of Medicine, Seodaemun-gu, Seoul , Korea (the Republic of)

Group or Team Name

  • KNOW-KT Study group
Background

Vitamin D [25(OH)D] insufficiency and FGF-23 elevation in chronic kidney disease (CKD) is usually ameliorated after kidney transplantation (KT). However, post-transplant vitamin D insufficiency are still associated with poor graft outcome. This study aimed to investigate the effect of pretransplant FGF-23 level on post-transplant vitamin D status and clinical outcomes.

Methods

The KoreaN cohort study for Outcome in patients With Kidney Transplantation (KNOW-KT) is a multicenter, observational cohort study. Four hundred subjects for whom serum FGF-23 measurement was available, were included in this study. Annual serum 25(OH)D and clinical outcomes; all-cause mortality, cardiovascular event, graft survival, and fracture were assessed according to baseline FGF-23 levels.

Results

Median follow-up duration was 6.5 years. Serum 25(OH)D3 levels were increased after KT (before KT, 12.6±7.4; 1 year after KT, 22.6±6.4; 3 years after KT, 24.3±5.8 ng/mL). However, they were declined to 20.9±9.2 ng/mL at 7 years after KT. Vitamin D deficiency was present in 79.1% just before KT, then it was decreased to 30.8% at 3 years after KT, whereas it was increased 37.8% at 6 years after KT. Serum FGF-23 level was decreased after KT [2140.6 (391-9277) pg/ml before KT vs. 50.0 (23.6-94.6) pg/ml at 3 years after KT, P=0.001]. The FGF-23 showed negative correlation with serum vitamin D levels. When we categorized subjects into tertile according to baseline GFG-23 level (low, middle, high FGF-23 groups), the 25(OH)D3 in the low baseline FGF-23 group was lowest at any point during follow-up. High baseline FGF-23 level was a risk factor for poor graft survival (HR 5.882, 95% C.I.; 1.443-23.976, P=0.022).

Conclusion

Increased FGF-23 could interfere vitamin D activation even after KT and is a risk factor for poor graft survival.