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  • Title: Clinical relevance of FGF-23 in chronic kidney disease.
    Author: Seiler S, Heine GH, Fliser D.
    Journal: Kidney Int Suppl; 2009 Dec; (114):S34-42. PubMed ID: 19946326.
    Abstract:
    Fibroblast growth factor (FGF)-23 is a recently discovered regulator of calcium-phosphate metabolism. Whereas other known FGFs mainly act in a paracrine manner, FGF-23 has significant systemic effects. Together with its cofactor Klotho, FGF-23 enhances renal phosphate excretion in order to maintain serum phosphate levels within the normal range. In patients with chronic kidney disease (CKD), FGF-23 levels rise in parallel with declining renal function long before a significant increase in serum phosphate concentration can be detected. However, in cross-sectional studies increased FGF-23 levels in patients with CKD were found to be associated not only with therapy-resistant secondary hyperparathyroidism but were also independently related to myocardial hypertrophy and endothelial dysfunction after adjustment for traditional markers of calcium-phosphate metabolism. Finally, in prospective studies high serum FGF-23 concentrations predicted faster disease progression in CKD patients not on dialysis, and increased mortality in patients receiving maintenance hemodialysis. FGF-23 may therefore prove to be an important therapeutic target in the management of CKD.
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