FGF23 LEVELS RAISE SIGNIFICANTLY IN FEMALE HIP

FRACTURE PATIENTS WITH POSTOPERATIVE AKI Sakan S, Bandic Pavlovic D, Basic-Jukic N, Kes P, Magas Vadlja J, Tonkovic D

Department of Anesthesiology and Intensive care, Jordanovac Clinical Department of Thoracic surgery,

Zagreb University Hospital Center,Jordanovac 104, Zagreb, Croatia

1.Goebel et al. J Orthop Res 2009;

27:1141-1146; Christov et al. Kidney

International 2013; 84:776-785.

Wang WJ et al. J Bone Miner Res

2104; 29.676-684

References

Postoperative AKI

-commom complication in hip fracture surgery

-female geneder independent predictor

-AKI incidence varies between 9% and 24%

- associated with higher postoperative

morbidity, mortality, longer hospital stay and

treatment costs

-FGF23 novel, early, renal biomarker of AKI

HYPOTHESIS

FGF23 is a novel, early renal biomarker of postoperative AKI

in female hip fracture patients

A pilot prospective cohort study during one month period

Inclusion criteria: female gender, trauma hip fracture

surgery, semi-scheduled surgery, age >18 years

Study included two groups:

1) AKI group N=9

- female subjects who developed AKI 24 h after operation

according to RIFLE/AKIN criteria

2) Control group N=7

- female subjects with normal renal function 24h after

operation

STUDY PROTOCOL

AKI group- plasma FGF23, serum creatinine, phosphate i

calcium measurements 24h after operation

Control group- plasma FGF23 and serum creatinine

measurement 24h after operation

Introduction 1

Methods 2

Results 3

AKI group FGF 23 levels were 39 times higher than

control group (2352 vs 61 RU/ml). Hypocalcemia

(median (IQR) 1,9 (1,70-2,01) mmol/l) and

normophosphatemia (median (IQR) 0,89 (0,56-1,51)

mmol/l) were recorded in the AKI group. Serum

creatinine showed the same pattern of changes as

FGF23 but not such large increase ( 354 vs 67 μmol/l)

4 Conclusion

Female AKI group Control group

N 9 7

Age* 80 (75-82) 75 (68-79)

Baseline serum

creatinine

μmol/l*

78 (70-82) 99 (82-107)

0

200

400

600

800

AKI group Control group

FGF23

FGF23

0

50

100

150

200

AKI group

Control group

Creatinine

Creatinine

Postoperative FGF23 levels showed

significantly high and rapid elevation in

AKI female hip fracture group.

Female AKI group Control group

Sepsis 1 0

Length of the

ICU stay (days)

6 (1,5-20) 2 (2-3)

Length of post

ICU stay (days)

9 (4-27) 10 (8-13)

Hospital

mortality

1 0

Postoperative

complications

1 0

Table 1

Figure 1

Figure 2 Figure 3

Table 2

0 1 2

3

Arterial hypertension

Diabetes mellitus

Cardiovascular

Pulmonary

N

N

*Median (IQR)

*Median (IQR)

39x 5.3x