Objective To analyze the relationship between serum fibroblast growth factor (FGF)-2 and FGF-23 levels and renal function and its short-term prognosis in sepsis patients with acute kidney injury (AKI) and treated by continuous renal replacement therapy (CRRT). Methods A total of 157 sepsis patients complicated with AKI and treated by CRRT were enrolled in this study. Serum FGF-2 and FGF-23 levels were compared among patients with different AKI stage. Patients were divided into survival group and death group according to the prognosis at day 28. Serum FGF-2 and FGF-23 levels and renal function indexes were compared between the two groups, and the correlations were analyzed. The predictive value of serum FGF-2 and FGF-23 levels for short-term prognosis of AKI was evaluated. Results In patients with AKI Ⅲ, serum FGF-2 level was lower and serum FGF-23 level was higher, as compared those with AKI Ⅱ (t=20.149 and -8.060, P＜0.001). Serum FGF-23, creatinine (Scr) and cystatin C levels were higher in the death group than in the survival group, while serum FGF-2 and eGFR were lower in the death group than in the survival group (t=-12.051, -17.462, -5.881, 25.990 and 15.997 respectively; P＜0.001). Pearson correlation analysis showed that serum FGF-2 was negatively correlated with Scr and cystatin C, and positively correlated with eGFR (r=-0.511, -0.449 and 0.606 respectively; P＜0.001, 0.002 and ＜0.001 respectively). Serum FGF-23 was positively correlated with Scr and cystatin C, and negatively correlated with eGFR (r=0.610, 0.522, -0.654 respectively; P＜0.001). The predictive value of combined application of serum FGF-2 and FGF-23 levels was higher than that of the two indicators applied individually (Z=2.120 and 2.034, P=0.034 and 0.042). Conclusion Serum FGF-2 level is significantly reduced and FGF-23 level is significantly increased in sepsis patients with AKI. The lower serum FGF-2 level and higher serum FGF-23 level are associated with the decreased renal function and poor short-term prognosis. Simultaneous use of serum FGF-2 and FGF-23 levels improves the prediction value for short-term prognosis in sepsis patients with AKI.
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