Correlation linking fibroblast growth factor 23 in circulation (FGF-23) and serum aldosterone levels in different stages of chronic kidney disease

Abstract

Abstract Background Chronic kidney disease (CKD) continues to pose a serious medical issue. To date, the detection of CKD relies on renal function estimate and radiology. Hence, new sensitive diagnostic and prognostic bioindicators are urgently needed for early diagnosis and surveillance of CKD. This study aimed to assess the correlation linking fibroblast growth factor 23 (FGF23) in circulation and serum aldosterone levels in cases with CKD of different stages and investigate the theory that aldosterone may directly cause elevated FGF23 secretion in these cases. Methods Our observational cross-sectional research was performed on 140 patients divided into: group A: 70 cases with diverse stages of recently discovered CKD that had not yet begun treatment with renin–angiotensin–aldosterone system (RAAS) blockers (CKD stages 1–5) and group B: 70 normal control subjects. Results The levels of serum aldosterone and circulating FGF-23 levels varied significantly among CKD cases. High levels of circulating FGF-23 and serum aldosterone each considerably raise the risk of CKD by 1.15 and 1.043 times, correspondingly. With a sensitivity of 91.4%, a specificity of 90%, a positive predictive value of 90.1%, a negative predictive value of 91.3%, and an overall accuracy of 90.7%. The optimal cutoff value for FGF-23 was a prediction of kidney damage at ≥ 59,735 ( p < 0.001). Patients’ FGF-23 levels and their CKD stages showed a strong correlation. For renal damage prediction, the optimal cutoff value for aldosterone is ≥ 117.59, with an area under the curve of 0.978, a sensitivity of 92.9%, a specificity of 88.6%, a positive predictive value of 89%, a negative predictive value of 92.5%, and an overall accuracy of 90.7% ( p < 0.001). Our study found that FGF-23, age, and estimated glomerular filtration rate (eGFR) were the sole factors strongly related to aldosterone in CKD patients. Conclusion There was a significant correlation linking circulating FGF23 and serum aldosterone levels among CKD cases, suggesting their potential as independent predictors of CKD progression. Both circulating FGF23 and aldosterone levels were considerably elevated in CKD cases in comparison with normal controls, highlighting their predictive performance.