Evidence mapPaperPMID 24164913Full record

Trial reportHemodialysis international. International Symposium on Home Hemodialysis2014

FGF-23 and cognitive performance in hemodialysis patients.

David A Drew, Hocine Tighiouart, Tammy M Scott, Kristina V Lou, Li Fan, Kamran Shaffi, Daniel E Weiner, Mark J Sarnak

Abstract readClinical Trial
In one paragraph

Trial report in Hemodialysis international. International Symposium on Home Hemodialysis, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 2 pooled it
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.

  1. Cognitive Impairment in End Stage Renal Disease Patients Undergoing Hemodialysis: Markers and Risk Factors.International journal of environmental research and public health · 2022
    Pooled it
  2. Pooled it
  3. Article
  4. Brain-Bone Axis in Physiological and Pathological Conditions.International journal of molecular sciences · 2025
    Review
  5. Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Review
  14. Plasma and CSF biomarkers of aging and cognitive decline in Caribbean vervets.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
    Article
  15. Review
  16. Article
  17. Article
  18. Review
  19. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

David A DrewDivision of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA, USA.
Hocine Tighiouart
Tammy M Scott
Kristina V Lou
Li Fan
Kamran Shaffi
Daniel E Weiner
Mark J Sarnak
Tufts Medical Center · US

Funding

EPIDEMIOLOGY, CLINICAL TRIALS AND OUTCOMES RESEARCHT32DK007777 · TUFTS MEDICAL CENTER · 1999 to 2005
$1.3M
Cardiac Risk Factors in Chronic Kidney DiseaseR21DK068310 · TUFTS MEDICAL CENTER · 2005 to 2005
$204k
Kidney Disease, Stroke and Cognitive ImpairmentK23DK071636 · TUFTS MEDICAL CENTER · 2005 to 2005
$126k
NIDDK NIH HHS K23 DK071636NIDDK NIH HHS K23 DK71636NIDDK NIH HHS K24 DK078204NIDDK NIH HHS R01 DK078204NIDDK NIH HHS R01 DK080112NIDDK NIH HHS R21 DK068310NIDDK NIH HHS T32 DK007777
6 · The paper itself

Abstract

Although cognitive impairment is common in hemodialysis patients, the etiology of and risk factors for its development remain unclear. Fibroblast growth factor 23 (FGF-23) levels are elevated in hemodialysis patients and are associated with increased mortality and left ventricular hypertrophy. Despite FGF-23 being found within the brain, there are no prior studies assessing whether FGF-23 levels are associated with cognitive performance. We measured FGF-23 in 263 prevalent hemodialysis patients in whom comprehensive neurocognitive testing was also performed. The cross-sectional association between patient characteristics and FGF-23 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 FGF-23 and each factor. Mean age was 63 years, 46% were women and 22% were African American. The median FGF-23 level was 3098 RU/mL. Younger age, lower prevalence of diabetes, longer dialysis vintage, and higher calcium and phosphorus were independently associated with higher FGF-23 levels. Higher FGF-23 was independently associated with a lower memory score (per doubling of FGF-23, β = -0.08 SD [95% confidence interval, CI: -0.16, -0.01]) and highest quartile vs. lowest quartile (β = -0.42 SD [-0.82, -0.02]). There was no definite association of FGF 23 with executive function when examined as a continuous variable (β = -0.03 SD [-0.10, 0.04]); however, there was a trend in the quartile analysis (β = -0.28 SD [-0.63, 0.07], P = 0.13, for 4th quartile vs. 1st quartile). FGF-23 was associated with worse performance on a composite memory score, including after adjustment for measures of mineral metabolism. High FGF-23 levels in hemodialysis patients may contribute to cognitive impairment.

Indexed as

CognitionAdultAgedAge FactorsCognition DisordersCross-Sectional StudiesFibroblast Growth Factor-23Fibroblast Growth FactorsHumansHypertrophy, Left VentricularMiddle AgedPrevalenceRenal DialysisSex FactorsFGF23 protein, humanFibroblast Growth Factor-23Fibroblast Growth FactorsCognitionFGF-23hemodialysis

Identifiers

PMID24164913
PMCPMC4443906
OpenAlexW2111046765

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.