Comparison of Serum FGF23 Levels and CKD-MBD Parameters in Home Hemodialysis and Center Hemodialysis

Purpose:This study aims to compare serum fibroblast growth factor 23 (FGF23) levels and chronic kidney disease-mineral and bone disorder (CKD-MBD) parameters in patients undergoing home hemodialysis (HHD) and center hemodialysis (CHD). Materials and methods: A total of 42 patients over 18 years old who had been receiving dialysis treatment for at least six months were included in the study. The patients were divided into two groups: HHD (n=17) and CHD (n=25). Demographic data, dialysis duration, biochemical parameters (serum phosphorus, calcium, parathyroid hormone, albumin, hemoglobin, FGF23, etc.), and medication use were recorded. Serum FGF23 levels were measured using the ELISA method from blood samples taken before midweek HD sessions. Frequency distributions were expressed as percentages and compared using the chi-square test. Results: The Kt/V values were higher in the HHD group (2.4±0.1 vs. 1.6±0.1), while serum phosphorus levels were lower (4.1±1.1 vs. 5.0±1.2 mg/dL). Although FGF23 levels were lower in the HHD group, the difference was not statistically significant (383±423 vs. 441±480 pg/mL, p>0.05). Erythropoietin (Epo) usage was significantly lower in the HHD group (47% vs. 92%, p=0.001). Conclusion: HHD was associated with better phosphorus control and a reduced requirement for EPO compared to CHD. The lower FGF23 levels in HHD suggest that this modality may offer advantages in CKD-MBD, cardiovascular outcomes, and mortality. However, these findings need to be supported by prospective studies involving larger patient populations.