Circulating fibroblast growth factor 23 in children on peritoneal dialysis is associated with effective dialysis

Our purpose was to assess the relationship between serum fibroblast growthfactor 23 (FGF23) and left ventricular function, carotid intima-media thickness(CIMT) and laboratory features in children on peritoneal dialysis (PD).The study population consisted of 17 patients (11 female; median age 7.83years, range 0.66-17.75) undergoing PD for 22 months (range 2-98). SerumFGF23, serum phosphorus, calcium, intact parathyroid hormone (iPTH),25(OH) vitamin D, 1,25(OH)2 vitamin D and Kt/V urea, left ventricular mass(LVM) and LVM index (LVMI) were assessed.Median FGF23 level was 29.92 pg/ml (22.7-74.76), phosphorus was 5.2 mg/dl(3.1-9.9), iPTH was 438 pg/ml (16-1446), 25(OH) vitamin D was 11 ng/ml(5-35), 1,25(OH)₂ vitamin D was 11 pg/ml (2-106), Kt/V urea was 2.33 (1.01-3.84). FGF23 level was independently associated with Kt/V urea (p<0.001).We found that effective dialysis may be the leading determinant of FGF level,independent from the calcium-phosphorus-PTH axis, in pediatric PD patients.