Effect of Fibroblast Growth Factor-23 (FGF-23) on Two-Year Mortality Rate in Chronic Kidney Disease Patients With Hemodialysis
Introduction Chronic kidney disease (CKD) is a global problem with increasing prevalence, poor prognosis, and high costs. Most deaths of CKD patients with hemodialysis (HD) is cardiovascular disorders. One of risk factors related to cardiovascular disorder is Fibroblast Growth Factor-23 (FGF-23). FGF-23 level is associated with increased mortality in CKD patients with HD. Aim & Objectives The aim of this study is to show the effect of Fibroblast Growth Factor-23 (FGF-23 on two year mortality rate in chronic kidney disease patients with hemodialysis. Materials and Method This retro-prospective mixcohort study with survival analysis obtained data from medical records of CKD patients undergoing HD at the Rasyidah Renal Hospital in the first week of January 2018. Patients were followed up next two years until 31st of December 2019. Kaplan Meier analysis was used to determine the effect of independent variables on dependent variable that was two years mortality, multivariate cox regression analysis to determine the dominant factor and magnitude of the association between independent variable and dependent variable. P-value <0.05 indicates a significant association. Result Kaplan Meier curve showed significant effect of FGF-23 level and Diabetes Mellitus on a two-year survival rate of patients (p = 0.01 and p = 0.04). Based on cox regression multivariate analysis, it was found patients with FGF-23 levels> 365ng/ml had a risk of 3.53 (CI95% 1,104-11,337) times more than group of patients with FGF-23 ≤ 365ng/ml while the presence of diabetes mellitus was risk factor on mortality with HR 3.71 (CI 1,279-10,796). Conclusion Statistically, FGF-23 level> 365 ng/ml is dominant factor that significantly influences 2-year mortality rate of CKD patients with HD other than Diabetes Mellitus. Key Words: Fibroblast Growth Factor, Chronic kidney disease on Hemodialysis, Mortality