Correlation of Fibroblast Growth Factor-23 Levels with Hand Grip Strength in Twice Weekly Hemodialysis Patients

Abstract

Introduction Fibroblast Growth Factor-23 (FGF-23), a hormone central to mineral metabolism, is increasingly recognized as a key biomarker in chronic kidney disease (CKD). Elevated FGF-23 levels in hemodialysis patients are linked to adverse outcomes, yet the specific correlation with functional measures like muscle strength remains poorly understood. This review synthesizes literature on the role of FGF-23 in hemodialysis patients, focusing on its established links to mortality and bone disease, and explores the evidence gap regarding its association with hand grip strength.

Methods This abstract is based on a literature review that synthesizes findings from multiple clinical studies and reviews. The analysis examined the role of FGF-23 in patients undergoing hemodialysis, focusing on its documented association with bone metabolism, cardiovascular risk, and mortality, while also assessing the literature for evidence of a direct link to muscle strength.

Results in patients with end-stage kidney disease and rise as CKD progresses. High circulating FGF-23 is a strong and independent predictor of increased mortality, cardiovascular events, and adverse bone health outcomes, including high bone turnover and mineralization defects. However, the reviewed studies reveal a significant gap in understanding the direct relationship between elevated FGF-23 levels and muscle strength, as measured by hand grip strength.

Discussion The robust evidence linking FGF-23 to mortality and cardiovascular disease establishes it as a critical prognostic biomarker in the hemodialysis population. While its function in CKD-Mineral and Bone Disorder is well-documented, its broader systemic effects are still being uncovered. The lack of clear data on its direct influence on sarcopenia and functional muscle status, such as hand grip strength, represents a crucial area for future research. This suggests that while elevated FGF-23 is a marker of systemic illness, its specific role in muscle wasting requires dedicated investigation.

Conclusion FGF-23 is a vital biomarker for predicting mortality and cardiovascular risk in patients undergoing hemodialysis. Although its role in bone metabolism is well-established, its direct correlation with hand grip strength is not yet clear. Further research is necessary to elucidate the mechanisms linking FGF-23 to muscle function to improve functional outcomes in this vulnerable population.