Circulating FGF‐23 Is Associated With Increased Risk of Osteoporosis and Fractures in Hemodialysis Patients: A Prospective Observational Study

Abstract

Background and Objective: It is still controversial whether circulating fibroblast growth factor 23 (FGF‐23) can be used as a biomarker for the diagnosis of osteoporosis and fractures in patients with chronic kidney disease undergoing hemodialysis. We investigated the association of circulating FGF‐23 concentrations with an increased risk of osteoporosis and fractures of hemodialysis patients in the prospective study.Methods: These data were collected in adult patients with hemodialysis in China from January 1 to December 30, 2016, and patients were followed up for 3.5 years. The association of circulating FGF‐23 with the risk of osteoporosis and fractures was analyzed by multivariate analysis.Results: The study included 1788 hemodialysis patients, with a median age of 56 years (50–64 years) and a female population of 54.5%. Of 1788 patients, 389 (21.8%) developed osteoporosis and 207 (11.6%) developed fractures. High concentrations of FGF‐23 were significantly related to osteoporosis and fractures and were significantly related to different types of fractures (vertebral fractures, nonvertebral fractures, and hip fractures). Adjusted for all potential risk factors, high concentrations of FGF‐23 were associated with the risk of osteoporosis or fractures.Conclusion: High concentrations of circulating FGF‐23 were associated with the risk of osteoporosis and fractures, including vertebral fractures and hip fractures. FGF‐23, along with bALP, CTX, and OC, may be used as a serum biomarker for predicting the risk of osteoporosis and fractures in patients with hemodialysis.