Chinese Journal of Blood Purification ›› 2024, Vol. 23 ›› Issue (02): 97-101.doi: 10.3969/j.issn.1671-4091.2024.02.004

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Relationship between serum FGF-2 and FGF-23 levels and renal function and its prognosis in sepsis patients with acute kidney injury and treated by continuous renal replacement therapy

LIN Ru, MA Ya-nan, ZHANG Jin-jin, WANG Rui-feng, LIU Gui-ling   

  1. Hemodialysis Section, Linyi Central Hospital, Linyi 276400, China; 2Department of Emergency, Linyi Central Hospital, Linyi 276400, China
  • Received:2023-09-18 Revised:2023-12-01 Online:2024-02-12 Published:2024-02-12
  • Contact: 276400 临沂,临沂市中心医院2急诊科 E-mail:13256578007@163.com

Abstract: Objective  To analyze the relationship between serum fibroblast growth factor (FGF)-2 and FGF-23 levels and renal function and its short-term prognosis in sepsis patients with acute kidney injury (AKI) and treated by continuous renal replacement therapy (CRRT).  Methods  A total of 157 sepsis patients complicated with AKI and treated by CRRT were enrolled in this study. Serum FGF-2 and FGF-23 levels were compared among patients with different AKI stage. Patients were divided into survival group and death group according to the prognosis at day 28. Serum FGF-2 and FGF-23 levels and renal function indexes were compared between the two groups, and the correlations were analyzed. The predictive value of serum FGF-2 and FGF-23 levels for short-term prognosis of AKI was evaluated.  Results  In patients with AKI Ⅲ, serum FGF-2 level was lower and serum FGF-23 level was higher, as compared those with AKI Ⅱ (t=20.149 and -8.060, P<0.001). Serum FGF-23, creatinine (Scr) and cystatin C levels were higher in the death group than in the survival group, while serum FGF-2 and eGFR were lower in the death group than in the survival group  (t=-12.051, -17.462, -5.881, 25.990 and 15.997 respectively; P<0.001). Pearson correlation analysis showed that serum FGF-2 was negatively correlated with Scr and cystatin C, and positively correlated with eGFR   (r=-0.511, -0.449 and 0.606 respectively; P<0.001, 0.002 and <0.001 respectively). Serum FGF-23 was positively correlated with Scr and cystatin C, and negatively correlated with eGFR (r=0.610, 0.522, -0.654 respectively; P<0.001). The predictive value of combined application of serum FGF-2 and FGF-23 levels was higher than that of the two indicators applied individually (Z=2.120 and 2.034, P=0.034 and 0.042).   Conclusion  Serum FGF-2 level is significantly reduced and FGF-23 level is significantly increased in sepsis patients with AKI. The lower serum FGF-2 level and higher serum FGF-23 level are associated with the decreased renal function and poor short-term prognosis. Simultaneous use of serum FGF-2 and FGF-23 levels improves the prediction value for short-term prognosis in sepsis patients with AKI.

Key words: Sepsis, Acute kidney injury, Continuous renal replacement therapy, FGF-2, FGF-23, Renal function, Prognosis

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