Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Fibroblast growth factor 23 (FGF23) has been associated with cognitive impairment in ESRD. Both FGF23 levels and cognition improve post-kidney transplantation (KT). It is unknown whether pre-KT FGF23 levels modify improvement in cognition.
*Methods: We assessed various domains of cognition pre-KT and 12 weeks post-KT with a battery of standard neuropsychological (NP) tests. We measured intact serum FGF23 (iFGF23) levels pre-and post-KT via ELISA CY-4000 (KAINOS Laboratories, Tokyo, Japan). We examined the correlation between pre-transplant iFGF23 levels and change in NP test performance pre to post-KT.
*Results: Twenty patients underwent iFGF23 and cognitive testing before and 12 weeks post-KT. Mean age was 49.8±11.6 years. Of the twenty, 12 were men and 19 were white. Mean iFGF23 prior to KT was 9060.8 (pg/ml) and 12 weeks post was 76.53 pg/ml (p = 0.004). Compared to pre-KT, Logical memory, Trailmaking B, Digit Symbol and Delayed Logical Memory all showed a statistically significant improvement post-KT.
|Time||MMSE (0-30)||Logical Memory (0-25)||Trail A (<150 s)||Trail B (<300 s)||Mean Trail (s)||Digit Symbol (0-93)||Delayed Logical Memory (0-25)|
|12 wk post-KT||28.7||14.85*||26.3||66.9**||50.3||50.7*||15.7*|
Correlation coefficient for pre-KT iFGF23 versus change in cognitive testing was (r=0.02, p=0.94) for MMSE, (r=0.05, p=0.82) for Logical Memory, (r=-0.27, (p=0.24) for Trailmaking A, (r=-0.15, p=0.52) for Digit Symbol, and (r=0.20, p=0.39) for Delayed Logical Memory. In contrast to these results, the correlation coefficients for Trailmaking B (r=-0.51, p=0.02) and Mean Trailmaking (r=0.48, p=0.03) revealed statistical significance.
*Conclusions: Intact FGF23 normalizes after successful KT. Compared to pre-KT, Logical memory, Trailmaking B, Digit Symbol and Delayed Logical Memory all showed significant improvement post-KT. Furthermore, high pre-KT iFGF23 level is associated with lack of improvement in cognition post-KT as demonstrated by Trailmaking B assessment. Trailmaking B shows potential as a specific NP domain that details predictive changes in executive function post-KT. Based upon our findings, further prospective studies are needed to validate these results.
To cite this abstract in AMA style:Klein JA, Jurgensen A, Stubbs J, Rowe P, Cibrik D, Brooks W, Burns J, Lauer Z, Gupta A. Pre Transplant Intact FGF 23 Modifies Post-Transplant Improvement in Cognition [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-transplant-intact-fgf-23-modifies-post-transplant-improvement-in-cognition/. Accessed February 27, 2021.
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