Serum FGF-23 Levels Predict The Efficacy Of Active Vitamin D Therapy In Dialysis Patients

Objective: To investigate the predictive value of FGF-23 level on the use of active vitamin D and analogues in patients with chronic renal disease complicated with secondary hyperparathyroidism.Objective to investigate the efficacy of vitamin D receptor agonist and active vitamin D receptor agonist in different levels of FGF-23 patients.Methods: a total of 177 regular hemodialysis patients with secondary hyperparathyroidism(PTH>300pg/ml)were selected at the the Xinjiang Uygur Autonomous Region people's hospital hemodialysis center.Patients with secondary hyperparathyroidism(PTH>300pg/ml)were exposed to high FGF-23 levels as exposure factors and decreased the baseline level by 40% as the main terminal event.High calcium occurred during the follow-up period.As a secondary focal event,hyperphosphatemia and hyperphosphatemia were divided into high FGF-23 combined low FGF-23 groups according to their FGF-23 level,and followed up with active vitamin D and analogue treatment according to the patient's original treatment program.The incidence of endpoint events was observed in December.At the same time,the two groups were divided into non selective vitamin D receptor agonist group and selective vitamin D receptor agonist group,and the probability of end-point events in the two groups was followed up.Results: In the high FGF3 group,25.84%(23/89)of the patients had the main endpoint events,while 71.59%(63/88)in the low FGF-23 group occurred(HR=0.74;95% CI 0.31-0.98;P < 0.001);in the high FGF-23 group,there were 24 cases(26.97%)with hypercalcemia,while 8(0.09%)in the low FGF-23 group(HR=3.01,95% CI 2.65).Hyperphosphatemia occurred in 61.80%(55/89)of high FGF-23 group,while 38.64%(34/88)occurred in low FGF-23 group(HR=2.64;95%CI2.19-2.86;p=0.025).The probability of major endpoint events in the low FGF-23 group was lower than that in the high FGF-23 group,and the probability of minor key events was significantly lower than that of the high FGF-23 group.In the ossified three alcohol group,76.92% of the patients in the low FGF-23 group had a major endpoint event,and 67.35% in the high FGF-23 group.The probability of the secondary end point of the two is equal.Conclusions: The study found that patients with a lower level of FGF-23 had significantly more effective treatment than those with lower levels,and the probability of hypercalcemia and hyperphosphatemia was also significantly reduced.