Abstract: Objective We investigated the significance of fibroblast growth factor 23 (FGF23) in maintenance hemodialysis (MHD) patients by measuring serum FGF23 and correlating FGF23 with intact parathyroid hormone levels (iPTH) and other biochemical markers in these patients. Methods Forty-one MHD patients were enrolled in this study, and 12 healthy individuals were used as the control group. Demographic information, serum FGF23 and other laboratory indexes were collected and analyzed. Results ① Serum FGF23 was significantly higher in MHD group than in control group (P＜0.01). ② When MHD patents were sub-grouped into group A (with lower iPTH level), group B (with normal iPTH level), and group C (with higher iPTH level). Serum FGF23 in the group A, B and C was 477.44±2293.53pg/ml, 176.57±402.39pg/ml and 1433.1±1984.76pg/ml, respectively, significantly different among the 3 groups (P=0.016). ③ When MHD patients were sub-grouped into hyperphosphatemia group and normal serum phosphate group. Compared to the normal serum phosphorus group, iPTH and FGF23 in the hyperphosphatemia group increased significantly (1319.66±1015.96pg/ml vs. 583.36±980.81pg/ml for iPTH, P<0.05; 1506.83±957.97pg/ml vs. 452.31±696.12pg/ml for FGF23, P＜0.001). ④ Serum FGF23 was positively correlated with serum calcium, phosphorus, ALP and calcium-phosphorus product (r=0.381, P<0.01 for calcium; r=0.593, P<0.001 for phosphorus; r=0.276, P<0.05 for ALP; r=0.656, P<0.001 for calcium-phosphorus product). iPTH was positively correlated with FGF23 in groups B and C (r=0.384, P<0.01), but not in group A. Conclusions In MHD patients, FGF23 was closely related to serum calcium, phosphorus, calcium-phosphorus product, ALP and iPTH. Therefore, FGF23 plays an important role in the presence of secondary hyperparathyroidism.

Key words: Hemodialysis, Fibroblast growth factor 23, Parathyroid hormone