{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T05:11:25Z","timestamp":1788757885201,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Phoenixin-14 (PNX-14) is a bioactive peptide associated with mitochondrial function, oxidative stress responses, and cellular protection. Although experimental data suggest a possible role in renal injury, its serum levels in chronic kidney disease (CKD) have not been previously studied. Given the limitations of conventional renal biomarkers, PNX-14 may offer additional information regarding renal dysfunction in CKD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This single-center, prospective, observational, cross-sectional study included 140 adult patients with Stage 3 CKD (\n n<\/jats:italic>\n \u2009=\u200930), Stage 4 CKD (\n n<\/jats:italic>\n \u2009=\u200930), Stage 5 CKD (\n n<\/jats:italic>\n \u2009=\u200930), and end-stage kidney disease receiving maintenance hemodialysis (HD) (\n n<\/jats:italic>\n \u2009=\u200950). Serum PNX-14 was measured using a commercial ELISA kit, before and after dialysis in HD patients. Associations between PNX-14 and clinical and laboratory parameters were assessed using Spearman correlation. Receiver operating characteristic (ROC) curve analysis evaluated the discriminative performance of PNX-14 across CKD stages.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Serum PNX-14 levels increased progressively with advancing CKD stage, from a median of 17.88 (IQR 15.16\u201320.20) pg\/mL in Stage 3\u201343.14 (IQR 23.78\u201395.71) pg\/mL in the HD group (\n p<\/jats:italic>\n \u2009&lt;\u20090.001).\n Post hoc<\/jats:italic>\n analysis showed that PNX-14 levels were significantly lower in Stage 3 than in Stage 5 and HD, in Stage 4 than in HD, and in Stage 5 than in HD. PNX-14 showed significant positive correlations with creatinine and parathyroid hormone (PTH) and a significant negative correlation with eGFR (all\n p<\/jats:italic>\n \u2009&lt;\u20090.001). In the pre-dialysis subgroup, PNX-14 remained significantly correlated with creatinine, eGFR, urea, and PTH. In HD patients, no significant difference was observed between pre-dialysis and post-dialysis PNX-14 levels (\n p<\/jats:italic>\n \u2009=\u20090.152), and no significant correlation was found between PNX-14 and Kt\/V. ROC analysis demonstrated good discriminative performance for distinguishing Stage 3 from advanced disease (Stage 5\u2009+\u2009HD), with an AUC of 0.839 (95% CI: 0.755\u20130.913). The optimal cut-off was 19.59 pg\/mL, with 87.5% sensitivity and 73.3% specificity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Serum PNX-14 levels increase with worsening CKD stage and are strongly associated with renal function parameters. Its limited change after HD and its discriminative performance suggest that PNX-14 may provide clinically relevant information regarding disease severity in CKD. Further prospective and longitudinal studies are needed to clarify its potential clinical utility.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1896542","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T04:22:55Z","timestamp":1788754975000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum phoenixin-14 levels in chronic kidney disease and hemodialysis patients: a cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Erdo\u011fan","family":"\u00d6zdemir","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Elaz\u0131\u011f Fethi Sekin City Hospital","place":["Elaz\u0131\u011f, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Gen\u00e7","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Elaz\u0131\u011f Fethi Sekin City Hospital","place":["Elaz\u0131\u011f, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turgay","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Elaz\u0131\u011f Fethi Sekin City Hospital","place":["Elaz\u0131\u011f, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deccane","family":"D\u00fczenci","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Elaz\u0131\u011f Fethi Sekin City Hospital","place":["Elaz\u0131\u011f, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2461","DOI":"10.1016\/S0140-6736(25)01853-7","article-title":"Global, regional, and national burden of chronic kidney disease in adults, 1990\u20132023, and its attributable risk factors: a systematic analysis for the global burden of disease study 2023","volume":"406","year":"2025","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1542329","DOI":"10.3389\/fpubh.2025.1542329","article-title":"Global burden of chronic kidney disease and risk factors, 1990\u20132021: an update from the global burden of disease study 2021","volume":"13","author":"Wang","year":"2025","journal-title":"Front Public Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","year":"2024","journal-title":"Kidney Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/S0140-6736(13)60687-X","article-title":"Chronic kidney disease: global dimension and perspectives","volume":"382","author":"Jha","year":"2013","journal-title":"Lancet"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.3390\/diagnostics15101225","article-title":"Emerging biomarkers and advanced diagnostics in chronic kidney disease: early detection through multi-omics and AI","volume":"15","author":"Alobaidi","year":"2025","journal-title":"Diagnostics (Basel)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"9156","DOI":"10.3390\/ijms24119156","article-title":"Recent advances in urinary peptide and proteomic biomarkers in chronic kidney disease: a systematic review","volume":"24","author":"Catanese","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1007\/s11255-022-03354-7","article-title":"Novel biomarkers for prognosticating diabetic kidney disease progression","volume":"55","author":"Swaminathan","year":"2023","journal-title":"Int Urol Nephrol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1111\/j.1365-2826.2012.02381.x","article-title":"A novel reproductive peptide, phoenixin","volume":"25","author":"Yosten","year":"2013","journal-title":"J Neuroendocrinol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"8378","DOI":"10.3390\/ijms21218378","article-title":"Phoenixin: more than reproductive peptide","volume":"21","author":"Billert","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B10","doi-asserted-by":"publisher","first-page":"956500","DOI":"10.3389\/fmolb.2022.956500","article-title":"Regulation and physiological functions of phoenixin","volume":"9","author":"Liang","year":"2022","journal-title":"Front Mol Biosci"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1076800","DOI":"10.3389\/fphar.2023.1076800","article-title":"Current state of phoenixin: the implications of the pleiotropic peptide in stress and its potential as a therapeutic target","volume":"14","author":"Friedrich","year":"2023","journal-title":"Front Pharmacol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1007\/s00018-017-2661-3","article-title":"Phoenixin-14: detection and novel physiological implications in cardiac modulation and cardioprotection","volume":"75","author":"Rocca","year":"2018","journal-title":"Cell Mol Life Sci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e70200","DOI":"10.1002\/jbt.70200","article-title":"Protective effects of phoenixin-14 administration against renal ischemia\/reperfusion injury in rats","volume":"39","author":"\u00d6z","year":"2025","journal-title":"J Biochem Mol Toxicol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New creatinine- and cystatin C-based equations to estimate GFR without race","volume":"385","author":"Inker","year":"2021","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1590\/1806-9282.20220153","article-title":"Investigation of serum phoenixin levels in patients with hypertension","volume":"68","author":"Akdu","year":"2022","journal-title":"Rev Assoc Med Bras (1992)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.2174\/0118715303267256231210060250","article-title":"The levels of phoenixin-14 and phoenixin-20 in patients with type 2 diabetes mellitus","volume":"24","author":"Can","year":"2024","journal-title":"Endocr Metab Immune Disord Drug Targets"},{"key":"B17","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1080\/14737159.2023.2216386","article-title":"An update on utilising brain natriuretic peptide for risk stratification, monitoring and guiding therapy in heart failure","volume":"23","author":"N\u00fa\u00f1ez-Mar\u00edn","year":"2023","journal-title":"Expert Rev Mol Diagn"},{"key":"B18","doi-asserted-by":"publisher","first-page":"6550","DOI":"10.3390\/cimb45080413","article-title":"Precision medicine in erythropoietin deficiency and treatment resistance: a novel approach to management of anemia in chronic kidney disease","volume":"45","author":"Yugavathy","year":"2023","journal-title":"Curr Issues Mol Biol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"687","DOI":"10.3390\/antiox13060687","article-title":"Role of uremic toxins, oxidative stress, and renal fibrosis in chronic kidney disease","volume":"13","author":"Fr\u0105k","year":"2024","journal-title":"Antioxidants (Basel)"},{"key":"B20","doi-asserted-by":"publisher","first-page":"77722","DOI":"10.18632\/oncotarget.20773","article-title":"Protein-bound uremic toxins impaired mitochondrial dynamics and functions","volume":"8","author":"Sun","year":"2017","journal-title":"Oncotarget"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1406531","DOI":"10.3389\/fendo.2024.1406531","article-title":"A systematic scoping review of the multifaceted role of phoenixin in metabolism","volume":"15","author":"Muzammil","year":"2024","journal-title":"Front Endocrinol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1007\/s00380-021-02011-w","article-title":"Kinetics of atrial and brain natriuretic peptides during hemodialysis are regulated in association with different cardiac functional changes","volume":"37","author":"Horio","year":"2022","journal-title":"Heart Vessels"},{"key":"B23","doi-asserted-by":"publisher","first-page":"10371","DOI":"10.1038\/s41598-017-10981-z","article-title":"A novel mathematical model of protein-bound uremic toxin kinetics during hemodialysis","volume":"7","author":"Maheshwari","year":"2017","journal-title":"Sci Rep"},{"key":"B24","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1007\/s40620-017-0393-y","article-title":"Acetate-free biofiltration to remove fibroblast growth factor 23 in hemodialysis patients: a pilot study","volume":"31","author":"Cernaro","year":"2018","journal-title":"J Nephrol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/j.kint.2024.11.013","article-title":"Chronic kidney disease-mineral and bone disorder: conclusions from a kidney disease: improving global outcomes (KDIGO) controversies conference","volume":"107","author":"Ketteler","year":"2025","journal-title":"Kidney Int"},{"key":"B26","article-title":"Chronic kidney disease","volume-title":"StatPearls","author":"Vaidya","year":"2024"},{"key":"B27","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1002\/9781118548387","volume-title":"Applied Logistic Regression","author":"Hosmer","year":"2013"},{"key":"B28","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1186\/s12882-024-03875-6","article-title":"Relationship between serum levels of LOX-1, hs-cTnT, NGAL, and renal function, and their diagnostic value in patients with chronic kidney disease: a retrospective study","volume":"25","author":"Chai","year":"2024","journal-title":"BMC Nephrol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"697","DOI":"10.3390\/medicina62040697","article-title":"Association of phoenixin-14 with body mass index categories and proteinuria in adults with type 2 diabetes","volume":"62","author":"Timurkaan","year":"2026","journal-title":"Medicina (Kaunas)"},{"key":"B30","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1093\/clinchem\/47.5.901","article-title":"Heparin-induced release of protein-bound solutes during hemodialysis is an in vitro artifact","volume":"47","author":"De Smet","year":"2001","journal-title":"Clin Chem"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1896542\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T04:22:57Z","timestamp":1788754977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1896542\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":30,"alternative-id":["10.3389\/fmed.2026.1896542"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1896542","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"article-number":"1896542"}}