Levels of FGF-23, C-Reactive Protein, Alkaline Phosphatase as A Risk Factor for Renal Osteodystrophy in Chronic Kidney Disease Patients Stage IV-V

Abstract

The condition of CKD is closely related to the existence of systemic disorders that affect various organs, including organs that often experience effects are the kidneys and musculoskeletal. Cases of osteoporosis are often found in patients with CKD who are commonly known as having Renal Osteodystrophy, which is defined by the presence of disorders or pathological conditions in the bones associated with CKD conditions. FGF-23, CRP, ALP are markers that have been associated with the occurrence of a renal osteodystrophy. By conducting this research, it is expected to know the relationship between the three markers and the occurrence of renal osteodystrophy. This study used a case-control design with a cross-sectional method to determine the relationship between FGF-23, CRP, ALP and renal osteodystrophy. From the CKD population with or without renal osteodystrophy, the sample was selected by consecutive sampling. After that, statistical tests were carried out in the form of descriptive tests, normality tests, risk factor assessment using 2x2 cross-tabulations, and predictive analysis of proportions using logistic regression tests. FGF-23 levels > 30 pg/ml (p-value <0.001; CI = 1.4-6.7), CRP > 3 mg/L (p-value <0.001; CI = 1.3-4.8), ALP > 120 U/L (p-value <0.001; CI = 1.7-10.6) in patients with stage IV-V CKD significantly increased the risk of renal osteodystrophy. In the multivariate analysis, ALP had the most significant value compared to these three variables. Based on this study, increased serum ALP is the most influential risk factor for renal osteodystrophy, both based on bivariate and multivariate analysis.