Pre Transplant Intact FGF 23 Modifies Post-Transplant Improvement in Cognition
1Nephrology, University of Kansas Medical Center, Kansas City, KS, 2KU Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, 3Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, 4Internal Medicine, University of Kansas Medical Center, Kansas City, KS
Meeting: 2019 American Transplant Congress
Abstract number: C122
Keywords: Kidney transplantation, Monitoring
Session Information
Session Name: Poster Session C: Kidney Psychosocial
Date: Monday, June 3, 2019
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) |
| Pre-KT | 28.4 | 11.65 | 24.1 | 80.7 | 55.7 | 47.7 | 10.6 |
| 12 wk post-KT | 28.7 | 14.85* | 26.3 | 66.9** | 50.3 | 50.7* | 15.7* |
|
p<0.05* p<0.10** |
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 June 15, 2021.« Back to 2019 American Transplant Congress