Nephron index [urinary phosphate: serum fibroblast growth factor 23 ratio]- a marker for atherosclerosis in diabetic predialysis chronic kidney disease patients.

UNLABELLED

Chronic kidney disease (CKD) is a global health problem, a leading cause of death and disability worldwide, estimated to affect more than 10% of the population Fibroblast growth factor - 23 (FGF 23), is a novel hormone, which is secreted primarily by the osteoblasts. It has been proposed that the ratio of Urinary phosphate (U-P) excretion (mg/day) to FGF23 as an index that theoretically represents the number of nephrons (nephron index)1. In this study, an attempt was made to establish the relationship between the Nephron index and degree of atherosclerosis (CIMT-Carotid intimal medial thickness) in predialysis CKD patients.

MATERIAL

110 predialysis CKD patients were selected after fulfilling the inclusion and exclusion criteria and their CIMT, Serum FGF 23 levels and various other baseline characteristics and demographic information were collected from August 1, 2020 to March 31, 2021 in this cross-sectional observational study, which was done in the medicine wards of a tertiary care hospital in Delhi.

OBSERVATION

The mean Age was 43.80 ± 15.08 years. The mean Body Weight (Kg) was 63.36 ± 8.37. The mean Nephron Index in the study population was 2.80 ± 3.55. The mean 24 hr urinary phosphate was 1026.03 ± 784.83 mg and the mean FGF-23 levels were 564.60 ± 194.16pg/ml. There was a moderate negative correlation between CIMT (mm) and Nephron Index (r = -0.39, p = <0.001).

CONCLUSION

Nephron Index was found to have an association with age, S. Creatinine, S.Calcium, S.Phosphate, iPTH, 24-Hour Urinary PO4, FGF-23, CIMT, eGFR, CKD stage, and CIMT. Nephron index may be used as a marker for atherosclerosis in predialysis CKD patients.