Fibroblast growth factor 23 in chronic kidney disease: New insights and clinical implications.
Fibroblast growth factor 23 (FGF-23) is a recently discovered regulator of phosphate and mineral metabolism. Its main physiological function is the enhancement of renal phosphate excretion. FGF-23 levels are inversely related to renal function and in patients with chronic kidney disease (CKD) elevation in FGF-23 precedes the rise of serum phosphate. Studies have demonstrated an important role for FGF-23 in the development of secondary hyperparathyroidism through an effect on parathyroid hormone and calcitriol. In cross-sectional studies FGF-23 has been associated with surrogate markers of cardiovascular disease such as endothelial dysfunction and arterial stiffness. FGF-23 has also been associated with both progression of CKD and mortality in dialysis patients. The discovery of FGF-23 has provided a profound new insight into bone and mineral metabolism, and it may become an important biomarker and therapeutic target in CKD.
Department of Nephrology, Monash Medical Centre, Monash University, Clayton, Victoria, Australia. Matthew.Damasiewicz@monash.edu
Matthew J
MJ
Damasiewicz
Nigel D
ND
Toussaint
Kevan R
KR
Polkinghorne
D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism* / Q000503:physiopathology; D002117:Calcitriol / Q000378:metabolism; D002908:Chronic Disease; D018450:Disease Progression; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology / Q000378:metabolism; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016030:Kidney Transplantation; D010281:Parathyroid Hormone / Q000378:metabolism; D010710:Phosphates / Q000378:metabolism; D006435:Renal Dialysis
D015415:Biomarkers; C000717427:FGF23 protein, human; C470125:PTH protein, human; D010281:Parathyroid Hormone; D010710:Phosphates; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002117:Calcitriol