Evaluation of the fibroblast growth factor-23 and bone minerals in renal transplant recipients: A follow-up study

Objectives: The objective of the study is to assess fibroblast growth factor-23 (FGF23) and its association with bone minerals in renal transplant recipients. Materials and Methods: A prospective longitudinal study comprising 32 end-stage renal disease cases awaiting renal transplant was followed up for three months post-transplant. Statistical analysis: Data were analyzed using appropriate tests such as the Freidman test, Pearson correlation with Statistical Package for the Social Sciences 20, and GraphPad Prism 7. P <0.05 was considered statistically significant. Results: A significant difference was noted in fibroblast growth factor 23 (FGF23) levels between pre and post-transplantation samples, with an increasing trend until 1 month, and a decreasing 1 by 3 months post-transplantation. Parathyroid hormone (PTH) levels reached normal ranges immediately post-transplant, and further decreased to lower normal ranges by three months. Vitamin D levels increased in the 1 st week and stabilized thereafter. Glomerular filtration rate (GFR) increased post-transplant immediately and stabilized in the following months. Calcium levels improved by 1 month post-transplant and stabilized thereafter. Phosphorus decreased in the immediate post-transplant period, and then a slight increase was noted. GFR has shown a negative correlation ( r = -0.24, P < 0.01) with FGF23 when pre and post-transplant samples were considered together. Phosphorus showed a positive correlation ( r = 0.3, P < 0.001) with FGF23. Pre-transplant ( r = 0.36, P < 0.044) and 3 months post-transplant ( r = 0.44, P = 0.025), FGF23 levels showed a positive correlation with phosphorus. FGF23 levels increase significantly post-transplantation within three months of stable graft function. An increase in phosphorus levels within the normal range was noted, with a significant positive correlation with FGF23. Conclusions: Greater information about aberrant FGF23 and its effects on bone minerals is necessary to understand whether efforts to restore it after transplant are desirable.