{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:18:59Z","timestamp":1770815939315,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"European Structural and Investment Funds","award":["POCI-01-0145-FEDER-016385"],"award-info":[{"award-number":["POCI-01-0145-FEDER-016385"]}]},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDB\/00051\/2020"],"award-info":[{"award-number":["UIDB\/00051\/2020"]}]},{"name":"European Structural and Investment Funds","award":["POCI-01-0145-FEDER-016385"],"award-info":[{"award-number":["POCI-01-0145-FEDER-016385"]}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/00051\/2020"],"award-info":[{"award-number":["UIDB\/00051\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background<\/jats:p>\n                  <jats:p>High levels of FGF23 associate with adverse events in CKD. The urinary fractional excretion of phosphate (FePi) might modify this association, although data are limited in moderate and advanced CKD. We investigated the association of combined FePi and serum FGF23 with incident heart failure, cardiovascular events and mortality in patients with\u00a0CKD stages\u00a02\u20134.<\/jats:p>\n                  <jats:p>Methods<\/jats:p>\n                  <jats:p>Patients from the Chronic Renal Insufficiency Cohort were divided into four groups according to the median of FePi and FGF23: low-FePi\/low-FGF23, reference group; high-FePi\/low-FGF23; low-FePi\/high-FGF23; high-FePi\/high-FGF23. Primary outcomes were: the composite of cardiovascular death or hospitalization for heart failure; cardiovascular death; hospitalization for heart failure; and death from any cause. Survival analysis and adjusted regression analyses were performed.<\/jats:p>\n                  <jats:p>Results<\/jats:p>\n                  <jats:p>We analyzed 3684 patients with a mean age of 58\u2009\u00b1\u200911\u00a0years of whom 45% were male. Mean eGFR was 44\u2009\u00b1\u200915\u00a0ml\/min\/1.73\u00a0m2. The median time of follow-up was 12 (IQR 7\u201313) years. The risk of the composite of cardiovascular death or hospitalization for heart failure was increased in the low-FePi\/high-FGF23 group (HR 1.35; 95%CI 1.09\u20131.67) and in the high-FePi\/high-FGF23 group (HR 1.50; 95%CI 1.20\u20131.86), compared to the low-FePi\/low-FGF23 group. Cardiovascular death and hospitalization for heart failure were also increased in both groups with high FGF23. Death from any cause was increased in the low-FePi\/high-FGF23 group (HR 1.56 (95%CI 1.30\u20131.89) and in the high-FePi\/high-FGF23 (HR 1.57 (95%CI 1.29\u20131.90)).<\/jats:p>\n                  <jats:p>Conclusions<\/jats:p>\n                  <jats:p>High FGF23 was associated with heart failure and cardiovascular death in patients with low FePi and high FePi with moderate to advanced CKD. This contrasts with reports in mild CKD.<\/jats:p>","DOI":"10.1007\/s40620-022-01358-1","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T09:03:50Z","timestamp":1654765430000},"page":"55-67","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Association of combined fractional excretion of phosphate and FGF23 with heart failure and cardiovascular events in moderate and advanced renal disease"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-3941","authenticated-orcid":false,"given":"Lu\u00eds","family":"Mendon\u00e7a","sequence":"first","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Professor Hern\u00e2ni Monteiro, 4200-319, Porto, Portugal 1"},{"name":"Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto, Porto, Portugal 2"}]},{"given":"Miguel","family":"Bigotte Vieira","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Curry Cabral, Centro Hospitalar Universit\u00e1rio de Lisboa Central, Lisbon, Portugal 3"}]},{"given":"Jo\u00e3o S\u00e9rgio","family":"Neves","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto, Porto, Portugal 2"},{"name":"Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal 4"}]}],"member":"286","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"issue":"5","key":"2026012307480096200_CR1","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1097\/MNH.0000000000000526","article-title":"Fibroblast growth factor 23 and phosphate homeostasis","volume":"28","author":"Balani","year":"2019","journal-title":"Curr 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January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors report no relationships that could be construed as a conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The CRIC Study protocol was approved by the institutional review boards of all participating centers: the University of Pennsylvania Institutional Review Board (Federalwide Assurance # 00004028), Johns Hopkins Institutional Review Board (Study # NA_00044034\/CIR00004697), The University of Maryland, Baltimore Institutional Review Board, University Hospitals Cleveland Medical Center Institutional Review Board, MetroHealth Institutional Review Board, Cleveland Clinic Foundation Institutional Review Board (IRB #5969), University of Michigan Medical School Institutional Review Board (IRBMED), Wayne State University Institutional Review Board, University of Illinois at Chicago Institutional Review Board, Tulane Human Research Protection Office, Institutional Review Boards, Biomedical Social Behavioral (reference#: 140987), and Kaiser Permanente Northern California Institutional Review Board.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The study is in accordance with the Declaration of Helsinki. All CRIC participants provided written informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}