{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:36:17Z","timestamp":1786649777658,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Fibroblast growth factor 23 (FGF23) is a protein encoded by the FGF23 gene in humans. It belongs to the FGF family, which plays a crucial role in phosphate and Vitamin D metabolism. The primary function of FGF23 appears to be regulating phosphate levels in plasma. Elevated FGF23 levels are consistently linked to left ventricular hypertrophy (LVH) and are a major risk factor for mortality in chronic kidney disease (CKD). We aimed to evaluate the role of FGF23 in assessing the association with LVH in dialyzed versus nondialyzed children with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>This prospective observational study involved 50 children with CKD divided into two groups: Group I consisted of 34 subjects undergoing regular hemodialysis, whereas Group II included 16 subjects not on hemodialysis. Various tests were done, including serum creatinine, calcium, phosphorus, and FGF23, along with echocardiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There was a statistically significant increase in FGF23 levels in dialyzed compared to nondialyzed patients. A significant positive correlation was found between serum FGF-23 levels and the duration of dialysis and serum phosphorus. In addition, a positive correlation was observed between FGF23 and left ventricular mass (LVM), LVM index (LVMI), and relative wall thickness (RWT). The area under the curve of FGF23 for identifying LVH was 0.803, with a sensitivity of 85.7% and specificity of 63.9%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Serum FGF-23 levels were significantly increased in dialyzed children compared to nondialyzed children. FGF-23 levels were significantly correlated with serum phosphorus levels, confirming the role of FGF23 in phosphate homeostasis. In addition, there were significant positive correlations between FGF23 levels and LVM, LVMI, and RWT, reinforcing FGF23\u2019s role in assessing the association with LVH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/apc.apc_83_25","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T18:00:33Z","timestamp":1767722433000},"page":"460-466","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Fibroblast growth factor 23 and left ventricular hypertrophy in dialyzed versus nondialyzed children with chronic kidney disease"],"prefix":"10.4103","volume":"18","author":[{"given":"Nagwan Yossery","family":"Saleh","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahima Mohammed","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona Salah","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hebatallah Mohammed","family":"Bahbah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salem Elsayed","family":"Deraz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt"},{"name":"Department of Pediatric, Emirates Health Services, Fujurah Hospital, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"17088","DOI":"10.1038\/nrdp.2017.88","article-title":"Chronic kidney disease","volume":"3","author":"Romagnani","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.kisu.2017.07.007","article-title":"Complications of chronic kidney disease: Current state, knowledge gaps, and strategy for action","volume":"7","author":"Bello","year":"2017","journal-title":"Kidney Int Suppl (2011)"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3389\/fped.2017.00101","article-title":"Left ventricular hypertrophy in pediatric hypertension: A mini review","volume":"5","author":"Woroniecki","year":"2017","journal-title":"Front Pediatr"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2215\/CJN.02110217","article-title":"FGF23 and left ventricular hypertrophy in children with CKD","volume":"13","author":"Mitsnefes","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3389\/fendo.2018.00189","article-title":"FGF23 actions on target tissues-with and without klotho","volume":"9","author":"Richter","year":"2018","journal-title":"Front Endocrinol (Lausanne)"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.bone.2016.09.010","article-title":"FGF23-klotho signaling axis in the kidney","volume":"100","author":"Erben","year":"2017","journal-title":"Bone"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"e20171904","DOI":"10.1542\/peds.2017-1904","article-title":"Clinical practice guideline for screening and management of high blood pressure in children and adolescents","volume":"140","author":"Flynn","year":"2017","journal-title":"Pediatrics"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4103\/0253-7176.116232","article-title":"How to calculate sample size for different study designs in medical research?","volume":"35","author":"Charan","year":"2013","journal-title":"Indian J Psychol Med"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"e0158765","DOI":"10.1371\/journal.pone.0158765","article-title":"Global prevalence of chronic kidney disease \u2013 A systematic review and meta-analysis","volume":"11","author":"Hill","year":"2016","journal-title":"PLoS One"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"a031260","DOI":"10.1101\/cshperspect.a031260","article-title":"Biology of fibroblast growth factor 23: From physiology to pathology","volume":"8","author":"Courbebaisse","year":"2018","journal-title":"Cold Spring Harb Perspect Med"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s00467-011-1939-1","article-title":"Epidemiology of chronic kidney disease in children","volume":"27","author":"Harambat","year":"2012","journal-title":"Pediatr Nephrol"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1007\/s00467-013-2504-x","article-title":"Left ventricular diastolic dysfunction by tissue Doppler echocardiography in pediatric chronic kidney disease","volume":"28","author":"Lindblad","year":"2013","journal-title":"Pediatr Nephrol"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s10157-012-0681-8","article-title":"Decreased physical function in pre-dialysis patients with chronic kidney disease","volume":"17","author":"Hiraki","year":"2013","journal-title":"Clin Exp Nephrol"},{"key":"R16-20260420","article-title":"A Profile of Renal Diseases in Egyptian Children","author":"Safouh","year":"1996","journal-title":"1st Pan Arab Pediatric Nephrology Conference. Cairo, Egypt"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"806","DOI":"10.4103\/1319-2442.160224","article-title":"Causes of chronic kidney disease in Egyptian children","volume":"26","author":"Safouh","year":"2015","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"R18-20260420","first-page":"468","article-title":"Hemodialysis in children: Eleven years in a single center in Egypt","volume":"7","author":"Youssef","year":"2013","journal-title":"Iran J Kidney Dis"},{"key":"R19-20260420","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1542\/pir.29.10.335","article-title":"Chronic kidney disease in children","volume":"29","author":"Whyte","year":"2008","journal-title":"Pediatr Rev"},{"key":"R20-20260420","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1056\/NEJMoa0706130","article-title":"Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis","volume":"359","author":"Guti\u00e9rrez","year":"2008","journal-title":"N Engl J Med"},{"key":"R21-20260420","first-page":"194","article-title":"Serum fibroblast growth factor 23 and calcium-phosphorus metabolism parameters in children with chronic kidney disease \u2013 Preliminary report","volume":"18","author":"Zi\u00f3\u0142kowska","year":"2014","journal-title":"Dev Period Med"},{"key":"R22-20260420","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1681\/ASN.V1251079","article-title":"Left ventricular hypertrophy in the renal patient","volume":"12","author":"Middleton","year":"2001","journal-title":"J Am Soc Nephrol"},{"key":"R23-20260420","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s00467-007-0734-5","article-title":"Global left-ventricular function by tissue Doppler imaging in pediatric dialysis patients","volume":"23","author":"U\u00e7ar","year":"2008","journal-title":"Pediatr Nephrol"},{"key":"R24-20260420","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/S0272-6386(12)80670-6","article-title":"Determinants of left ventricular hypertrophy and systolic dysfunction in chronic renal failure","volume":"24","author":"Greaves","year":"1994","journal-title":"Am J Kidney Dis"},{"key":"R25-20260420","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/S0735-1097(87)80350-9","article-title":"Left ventricular mechanics and contractile state in children and young adults with end-stage renal disease: Effect of dialysis and renal transplantation","volume":"10","author":"Colan","year":"1987","journal-title":"J Am Coll Cardiol"},{"key":"R26-20260420","doi-asserted-by":"crossref","first-page":"799","DOI":"10.3109\/08860229709037220","article-title":"Left ventricular morphology in chronic renal failure by echocardiography","volume":"19","author":"Raj","year":"1997","journal-title":"Ren Fail"},{"key":"R27-20260420","first-page":"297","article-title":"Echocardiographic assessment of cardiac dysfunction in patients of chronic renal failure","volume":"4","author":"Agarwal","year":"2003","journal-title":"J Indian Acad Clin Med"},{"key":"R28-20260420","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1111\/j.1523-1755.2004.00525.x","article-title":"Impaired left ventricular diastolic function in children with chronic renal failure","volume":"65","author":"Mitsnefes","year":"2004","journal-title":"Kidney Int"},{"key":"R29-20260420","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1093\/ndt\/gft382","article-title":"Short daily hemodialysis is associated with lower plasma FGF23 levels when compared with conventional hemodialysis","volume":"29","author":"Zaritsky","year":"2014","journal-title":"Nephrol Dial Transplant"},{"key":"R30-20260420","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1093\/ndt\/gfs411","article-title":"Fibroblast growth factor 23 and soluble klotho in children with chronic kidney disease","volume":"28","author":"Wan","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"R31-20260420","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1038\/ki.2010.107","article-title":"Fibroblast growth factor 23 and bone metabolism in children with chronic kidney disease","volume":"78","author":"van Husen","year":"2010","journal-title":"Kidney Int"},{"key":"R32-20260420","doi-asserted-by":"crossref","first-page":"3202","DOI":"10.1093\/ndt\/gfm347","article-title":"Regulation of fibroblast growth factor-23 in chronic kidney disease","volume":"22","author":"Westerberg","year":"2007","journal-title":"Nephrol Dial Transplant"},{"key":"R33-20260420","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1111\/j.1523-1755.2004.00604.x","article-title":"FGF-23 in patients with end-stage renal disease on hemodialysis","volume":"65","author":"Imanishi","year":"2004","journal-title":"Kidney Int"},{"key":"R34-20260420","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1159\/000377633","article-title":"Serum klotho: Relation to fibroblast growth factor-23 and other regulators of phosphate metabolism in children with chronic kidney disease","volume":"129","author":"Sawires","year":"2015","journal-title":"Nephron"},{"key":"R35-20260420","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1007\/s00467-012-2224-7","article-title":"Fibroblast growth factor 23 and left ventricular hypertrophy in children on dialysis","volume":"27","author":"Seeherunvong","year":"2012","journal-title":"Pediatr Nephrol"},{"key":"R36-20260420","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1007\/s00467-015-3125-3","article-title":"Relationship of FGF23 to indexed left ventricular mass in children with non-dialysis stages of chronic kidney disease","volume":"30","author":"Sinha","year":"2015","journal-title":"Pediatr Nephrol"},{"key":"R37-20260420","doi-asserted-by":"crossref","first-page":"4393","DOI":"10.1172\/JCI46122","article-title":"FGF23 induces left ventricular hypertrophy","volume":"121","author":"Faul","year":"2011","journal-title":"J Clin Invest"},{"key":"R38-20260420","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1681\/ASN.2013050465","article-title":"Fibroblast growth factor-23 and cardiovascular events in CKD","volume":"25","author":"Scialla","year":"2014","journal-title":"J Am Soc Nephrol"},{"key":"R39-20260420","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1681\/ASN.2009060609","article-title":"Masked hypertension associates with left ventricular hypertrophy in children with CKD","volume":"21","author":"Mitsnefes","year":"2010","journal-title":"J Am Soc Nephrol"},{"key":"R40-20260420","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1681\/ASN.2006060573","article-title":"Mineral metabolism and arterial functions in end-stage renal disease: potential role of 25-hydroxyvitamin D deficiency","volume":"18","author":"London","year":"2007","journal-title":"J Am Soc Nephrol"}],"container-title":["Annals of Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_83_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:58:18Z","timestamp":1786647498000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_83_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/apc.apc_83_25","relation":{},"ISSN":["0974-2069","0974-5149"],"issn-type":[{"value":"0974-2069","type":"print"},{"value":"0974-5149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-04-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}