Relationship between serum FGF-2 and FGF-23 levels and renal function and its prognosis in sepsis pa-tients with acute kidney injury and treated by continuous renal replacement therapy
Objective To analyze the relationship between serum fibroblast growth factor(FGF)-2 and FGF-23 levels and renal function and its short-term prognosis in sepsis patients with acute kidney injury(AKI)and treated by continuous renal replacement therapy(CRRT).Methods A total of 157 sepsis patients complicated with AKI and treated by CRRT were enrolled in this study.Serum FGF-2 and FGF-23 levels were compared among patients with different AKI stage.Patients were divided into survival group and death group according to the prognosis at day 28.Serum FGF-2 and FGF-23 levels and renal function indexes were compared between the two groups,and the correlations were analyzed.The predictive value of serum FGF-2 and FGF-23 levels for short-term prognosis of AKI was evaluated.Results In patients with AKI Ⅲ,serum FGF-2 level was lower and serum FGF-23 level was higher,as compared those with AKI Ⅱ(t=20.149 and-8.060,P＜0.001).Serum FGF-23,creatinine(Scr)and cystatin C levels were higher in the death group than in the survival group,while serum FGF-2 and eGFR were lower in the death group than in the survival group(t=-12.051,-17.462,-5.881,25.990 and 15.997 respectively;P＜0.001).Pearson correlation analysis showed that serum FGF-2 was negatively correlated with Scr and cystatin C,and positively correlated with eGFR(r=-0.511,-0.449 and 0.606 respectively;P＜0.001,0.002 and＜0.001 respectively).Serum FGF-23 was posi-tively correlated with Scr and cystatin C,and negatively correlated with eGFR(r-0.610,0.522,-0.654 respec-tively;P＜0.001).The predictive value of combined application of serum FGF-2 and FGF-23 levels was high-er than that of the two indicators applied individually(Z=2.120 and 2.034,P=0.034 and 0.042).Conclusion Serum FGF-2 level is significantly reduced and FGF-23 level is significantly increased in sepsis patients with AKI.The lower serum FGF-2 level and higher serum FGF-23 level are associated with the decreased renal function and poor short-term prognosis.Simultaneous use of serum FGF-2 and FGF-23 levels improves the prediction value for short-term prognosis in sepsis patients with AKI.
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