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Fibroblast growth factor 23 and left ventricular hypertrophy in dialyzed versus nondialyzed children with chronic

Nagwan Yossery Saleh1, Fahima Mohammed Hassan1, Mona Salah Habib2

  • 1Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt.

Annals of Pediatric Cardiology
|February 26, 2026
PubMed

Insights

Fibroblast growth factor 23 (FGF23) is elevated in children with chronic kidney disease (CKD) undergoing dialysis. Higher FGF23 levels correlate with left ventricular hypertrophy (LVH) in these pediatric CKD patients.

Area of Science:

  • Biochemistry
  • Pediatric Nephrology
  • Cardiology

Background:

  • Fibroblast growth factor 23 (FGF23) is integral to phosphate and Vitamin D metabolism.
  • Elevated FGF23 is linked to left ventricular hypertrophy (LVH) and mortality in chronic kidney disease (CKD).
  • FGF23's role in LVH assessment among pediatric CKD patients, particularly dialyzed versus nondialyzed, requires further evaluation.

Purpose of the Study:

  • To investigate the association between FGF23 levels and LVH in children with CKD.
  • To compare FGF23 levels in pediatric CKD patients undergoing hemodialysis versus those not on dialysis.

Main Methods:

  • A prospective observational study included 50 children with CKD, divided into hemodialysis (n=34) and nondialysis (n=16) groups.
  • Serum levels of creatinine, calcium, phosphorus, and FGF23 were measured.
  • Echocardiography was performed to assess cardiac parameters, including left ventricular mass (LVM), LVM index (LVMI), and relative wall thickness (RWT).

Main Results:

  • Serum FGF23 levels were significantly higher in dialyzed pediatric CKD patients compared to nondialyzed patients.
  • FGF23 levels showed a significant positive correlation with dialysis duration and serum phosphorus.
  • Positive correlations were observed between FGF23 and LVM, LVMI, and RWT, indicating an association with LVH.

Conclusions:

  • Serum FGF23 levels are significantly elevated in dialyzed children with CKD.
  • FGF23 levels correlate with serum phosphorus, supporting its role in phosphate homeostasis.
  • FGF23 is a valuable marker for assessing LVH in pediatric CKD patients, particularly those on dialysis.
Abstract

Keywords:
Chronic renal failurefibroblast growth factor familyheart failureleft ventricular mass

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