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Elevated serum FGF21 is an independent predictor for adverse events in hemodialysis patients from two large centers: a prospective cohort study.

Authors :
Li M
Jiang LQ
Zhang MY
Liu SS
Sawh RR
Zheng J
Yan Y
Hou SM
Lu KQ
Thorne O
Liu BC
Qian Q
Wu YF
Yang M
Wang B
Source :
Renal failure [Ren Fail] 2023; Vol. 45 (2), pp. 2256414. Date of Electronic Publication: 2023 Sep 19.
Publication Year :
2023

Abstract

Introduction: We explored the relationship and the predictive value of serum fibroblast growth factor 21 (FGF21) with all-cause mortality, major adverse cardiovascular events (MACEs) and pneumonia in hemodialysis (HD) patients. Methods: A total of 388 Chinese HD patients from two HD centers were finally enrolled in this prospective cohort study (registration number: ChiCTR 1900028249) between January 2018 and December 2018. Serum FGF21 was detected. Patients were followed up with a median period of 47 months to record the MACEs and pneumonia until death or 31 December 2022. Results: The incidence of all-cause mortality, MACEs and pneumonia in HD patients were 20.6%, 29.6%, and 34.8%, respectively. The optimal cutoffs for FGF21 to predict all-cause mortality, MACEs and pneumonia were 437.57 pg/mL, 216.99 pg/mL and 112.79 pg/mL. Multivariate Cox regression analyses showed that FGF21, as a categorical variable, was an independent predictor for all-cause mortality, MACEs and pneumonia (HR, 3.357, 95% CI, 2.128-5.295, p  < 0.001; HR, 1.575, 95% CI, 1.046-2.371, p  = 0.029; HR, 1.784; 95% CI, 1.124-2.830; p  = 0.014, respectively). The survival nomogram, MACEs-free survival nomogram and pneumonia-free survival nomogram based on FGF21 constructed for individualized assessment of HD patients had a high C-index with 0.841, 0.706 and 0.734. Conclusion: Higher serum FGF21 is an independent predictor of all-cause mortality, MACEs and pneumonia in HD patients.

Details

Language :
English
ISSN :
1525-6049
Volume :
45
Issue :
2
Database :
MEDLINE
Journal :
Renal failure
Publication Type :
Academic Journal
Accession number :
37724523
Full Text :
https://doi.org/10.1080/0886022X.2023.2256414