{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T02:06:39Z","timestamp":1793239599250,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,10,24]],"date-time":"2013-10-24T00:00:00Z","timestamp":1382572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although cognitive impairment is common in hemodialysis patients, the etiology of and risk factors for its development remain unclear. Fibroblast growth factor 23 (<jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023) levels are elevated in hemodialysis patients and are associated with increased mortality and left ventricular hypertrophy. Despite <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 being found within the brain, there are no prior studies assessing whether <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 levels are associated with cognitive performance. We measured <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 in 263 prevalent hemodialysis patients in whom comprehensive neurocognitive testing was also performed. The cross\u2010sectional association between patient characteristics and <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 levels was assessed. Principal factor analysis was used to derive two factors from cognitive test scores, representing memory and executive function, which carried a mean of 0 and a standard deviation of 1. Multivariable linear regression adjusting for age, sex, education status, and other relevant covariates was used to explore the relationship between <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 and each factor. Mean age was 63 years, 46% were women and 22% were African American. The median <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 level was 3098 <jats:styled-content style=\"fixed-case\">RU<\/jats:styled-content>\/mL. Younger age, lower prevalence of diabetes, longer dialysis vintage, and higher calcium and phosphorus were independently associated with higher <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 levels. Higher <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 was independently associated with a lower memory score (per doubling of <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023, \u03b2\u2009=\u2009\u22120.08 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> [95% confidence interval, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: \u22120.16, \u22120.01]) and highest quartile vs. lowest quartile (\u03b2\u2009=\u2009\u22120.42 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> [\u22120.82, \u22120.02]). There was no definite association of <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content> 23 with executive function when examined as a continuous variable (\u03b2\u2009=\u2009\u22120.03 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> [\u22120.10, 0.04]); however, there was a trend in the quartile analysis (\u03b2\u2009=\u2009\u22120.28 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> [\u22120.63, 0.07], P\u2009=\u20090.13, for 4th quartile vs. 1st quartile). <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 was associated with worse performance on a composite memory score, including after adjustment for measures of mineral metabolism. High <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>\u201023 levels in hemodialysis patients may contribute to cognitive impairment.<\/jats:p>","DOI":"10.1111\/hdi.12100","type":"journal-article","created":{"date-parts":[[2013,10,25]],"date-time":"2013-10-25T06:39:50Z","timestamp":1382683190000},"page":"78-86","source":"Crossref","is-referenced-by-count":54,"title":["<scp>FGF<\/scp>\u201023 and cognitive performance in hemodialysis patients"],"prefix":"10.1111","volume":"18","author":[{"given":"David A.","family":"Drew","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Medicine Tufts Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hocine","family":"Tighiouart","sequence":"additional","affiliation":[{"name":"The Institute for Clinical Research and Health Policy Studies Tufts Medical Center Tufts Clinical and Translational Science Institute Tufts University  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy M.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Tufts Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina V.","family":"Lou","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Tufts Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Fan","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Tufts Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamran","family":"Shaffi","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Tufts Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Weiner","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Tufts Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"J. 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