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316 PHOSPHATE WASTING AND FGF-23 KINETICS POST-RENAL TRANSPLANTATION.
  1. K. Wesseling1,
  2. H. Jueppner2,
  3. J. Lavigne3,
  4. R. Zahranik3,
  5. I. B. Salusky1
  1. 1David Geffen School of Medicine at UCLA, Los Angeles, CA
  2. 2Massachusetts General Hospital, Boston, MA
  3. 3Immutopics, San Clemente, CA.

Abstract

FGF-23 is a hormone linked to phosphate wasting in both animals and humans. S-FGF-23 levels are markedly elevated in patients with CKD but decline after renal transplantation. Phosphate retention is universal in dialyzed patients and wasting occurs after successful renal transplantation; however, the time course of decline of FGF-23 levels and its relationship to phosphate wasting in children have yet to be defined. Seventeen children ages 16.8 ± 0.6 years underwent renal transplantation. S-levels of FGF-23 (by intact and C-terminal assays), Ca, phos, and creatinine, as well as urine Ca, Phos, and creatinine, were measured at the time of transplant and daily post-transplant for 5 days. The coefficient of correlation between measurements of FGF-23 by the intact and C-terminal assays was r = .93 (p < .01). Intact FGF-23 correlated with s-creatinine (r = .43, p < .05) and s-phos (r = .35, p < .05) (Table 1). In the first 5 days after successful renal transplantation, s-FGF-23 levels decrease as s-Phos and decreases. The time course of decline in FGF-23 levels to near-normal range parallels that of serum creatinine, suggesting a predominant role for decreased renal clearance in its accumulation in dialyzed patients.

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