FGF-23 and cognitive performance in hemodialysis patients.
Hemodial Int
; 18(1): 78-86, 2014 Jan.
Article
en En
| MEDLINE
| ID: mdl-24164913
ABSTRACT
Although cognitive impairment is common in hemodialysis patients, the etiology of and risk factors for its development remain unclear. Fibroblast growth factor 23 (FGF-23) levels are elevated in hemodialysis patients and are associated with increased mortality and left ventricular hypertrophy. Despite FGF-23 being found within the brain, there are no prior studies assessing whether FGF-23 levels are associated with cognitive performance. We measured FGF-23 in 263 prevalent hemodialysis patients in whom comprehensive neurocognitive testing was also performed. The cross-sectional association between patient characteristics and FGF-23 levels was assessed. Principal factor analysis was used to derive two factors from cognitive test scores, representing memory and executive function, which carried a mean of 0 and a standard deviation of 1. Multivariable linear regression adjusting for age, sex, education status, and other relevant covariates was used to explore the relationship between FGF-23 and each factor. Mean age was 63 years, 46% were women and 22% were African American. The median FGF-23 level was 3098 RU/mL. Younger age, lower prevalence of diabetes, longer dialysis vintage, and higher calcium and phosphorus were independently associated with higher FGF-23 levels. Higher FGF-23 was independently associated with a lower memory score (per doubling of FGF-23, ß = -0.08 SD [95% confidence interval, CI -0.16, -0.01]) and highest quartile vs. lowest quartile (ß = -0.42 SD [-0.82, -0.02]). There was no definite association of FGF 23 with executive function when examined as a continuous variable (ß = -0.03 SD [-0.10, 0.04]); however, there was a trend in the quartile analysis (ß = -0.28 SD [-0.63, 0.07], P = 0.13, for 4th quartile vs. 1st quartile). FGF-23 was associated with worse performance on a composite memory score, including after adjustment for measures of mineral metabolism. High FGF-23 levels in hemodialysis patients may contribute to cognitive impairment.
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Base de datos:
MEDLINE
Asunto principal:
Diálisis Renal
/
Cognición
/
Trastornos del Conocimiento
/
Factores de Crecimiento de Fibroblastos
Tipo de estudio:
Etiology_studies
/
Observational_studies
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Prevalence_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Hemodial Int
Asunto de la revista:
NEFROLOGIA
/
TERAPEUTICA
Año:
2014
Tipo del documento:
Article