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Monitoring Hormone May Improve Kidney Failure Outcomes

Screening could work best for early-stage patients who don't yet need dialysis, study says

WEDNESDAY, Aug. 6 (HealthDay News) -- Monitoring levels of a hormone called fibroblast growth factor 23 (FGF-23) may help improve treatment of kidney failure patients, say Massachusetts General Hospital researchers.

Their analysis of patient data revealed that those who had elevated levels of FGF-23 when they began hemodialysis were much more likely to die within the first year of treatment, regardless of other risk factors.

Patients with the highest FGF-23 levels had a 600 percent higher death rate than those with the lowest levels. Patients with intermediate FGF-23 levels also had an increased risk of death.

"FGF-23 helps regulate serum phosphate levels; and we know that, among patients with kidney failure, elevated phosphate is associated with more rapid progression to renal failure and earlier death," study leader Dr. Myles Wolf said in an MGH news release. "The results of this study suggest that we need to be concerned about phosphate control even for patients whose serum phosphate levels are normal, and that may involve routine screening for FGF-23."

"Incorporating FGF-23 levels into the management of kidney failure may have its greatest potential for treatment of the millions of patients with early-stage kidney disease who do not yet require dialysis, who usually have normal phosphate levels but quite high FGF-23," Wolf added. "Routinely monitoring FGF-23 may help determine which patients need to begin therapies that control phosphate levels, which may reduce mortality in this very high-risk group."

The study was published in the Aug. 7 issue of the New England Journal of Medicine.

More information

The American Academy of Family Physicians has more about kidney failure.

-- Robert Preidt

SOURCE: Massachusetts General Hospital, news release, Aug. 6, 2008

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