Baseline intact fibroblast growth factor 23 and risk of kidney disease progression in the Indian Chronic Kidney Disease cohort: a prospective multicenter study

作者：Kajal Kamboj, Ashok Yadav, Aman Rastogi, Arpita Ghosh, Shubham Sharma, Love Jain, Vivek Kumar, Vivekanand Jha, Indian Chronic Kidney Disease Study Network · 发表于：Frontiers in Medicine · 年份：2026 · DOI：10.3389/fmed.2025.1707350 · 被引用次数：1 · 研究领域：Parathyroid Disorders and Treatments、Fibroblast Growth Factor Research、Dialysis and Renal Disease Management

Background Circulating levels of fibroblast growth factor 23 (FGF23) increase early in chronic kidney disease and are associated with a faster progression and increased mortality. However, evidence from South Asia is limited. We investigated the association between baseline intact FGF23 levels and adverse kidney outcomes in the ICKD cohort. Methods A prospective cohort of adult participants with mild to moderate CKD enrolled at 11 Indian hospitals was included if baseline FGF-23 levels were available. Plasma iFGF-23 was measured using a two-site ELISA. The primary endpoint was major adverse kidney events (MAKE: a composite of kidney failure, ≥50% decline in eGFR, or kidney death). Secondary endpoints included individual MAKE components, all-cause mortality, and cardiovascular mortality. Cox proportional hazards models were used to evaluate the associations between iFGF23 and time-to-event outcomes. Results A total of 602 participants were followed up for a median duration of 5.3 years. MAKE developed in 266 (49.3%) participants; 223 (41.3%) progressed to kidney failure; 211 (43.5%) reached ≥50% eGFR decline; and 66 (11.0%) died. iFGF23 was significantly associated with MAKE (SHR 1.23, 95% CI 1.02–1.47, p = 0.027), kidney failure (SHR 1.28, 95% CI 1.04–1.58, p = 0.02), and all-cause mortality (HR 1.39, 95% CI 1.05–1.83, p = 0.02) in unadjusted and age- and sex-adjusted Cox proportional hazards models. However, in the fully adjusted model with clinical variables, none of the as...