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Li M, Jiang LQ, Zhang MY, Liu SS, Sawh RRR, Zheng J, Yan Y, Hou SM, Lu KQ, Thorne O, Liu BC, Qian Q, Wu YF, Yang M, Wang B. Elevated serum FGF21 is an independent predictor for adverse events in hemodialysis patients from two large centers: a prospective cohort study. Ren Fail 2023; 45:2256414. [PMID: 37724523 PMCID: PMC10512844 DOI: 10.1080/0886022x.2023.2256414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023] Open
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.
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Affiliation(s)
- Min Li
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Li-qiong Jiang
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
- Department of Nephrology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Meng-yu Zhang
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Shu-su Liu
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | | | - Jing Zheng
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Yu Yan
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Shi-mei Hou
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Ke-qi Lu
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Obadele Thorne
- Department of Nephrology, Georgetown Public Hospital Corporation, Georgetown, Guyana
| | - Bi-cheng Liu
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Qing Qian
- Department of Pharmacy, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yan-feng Wu
- Department of Neurology, Nanjing Medical University Second Affiliated Hospital, Nanjing, China
| | - Min Yang
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Bin Wang
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
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