title: Fibroblast growth factor 23 predicts left ventricular mass and induces cell adhesion molecule formation.
abstract: Elevated FGF-23 is a predictor of mortality and is associated with LVH in CKD. It may be a biomarker or a direct toxin. We assessed the relationship between FGF-23 and LVH in CKD using CMRI. In vitro we studied the effect of phosphate, FGF-23, and Klotho on E-selectin and VCAM production in HUVECs. FGF-23 concentration correlates negatively with eGFR and positively with LVMI. FGF-23 was an independent predictor of LVH in CKD. E-selectin and VCAM production was elevated in HUVECs cultured in high phosphate with FGF-23 or Klotho. This effect was attenuated in cells exposed to both FGF-23 and Klotho. FGF-23 is an independent predictor of LVH as measured by CMRI. We show preliminary data which supports that FGF-23 is toxic resulting in activation of the vascular endothelium. We do not prove causality with elevated FGF-23 and LVH. Further research should ascertain if lowering levels of FGF-23 translates to improved clinical outcomes.
authors.affiliation: Renal Research Group, ICAMS, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
authors.forename: Kathryn K
authors.initials: KK
authors.lastname: Stevens
authors.forename: Emily P
authors.initials: EP
authors.lastname: McQuarrie
authors.forename: William
authors.initials: W
authors.lastname: Sands
authors.forename: Dianne Z
authors.initials: DZ
authors.lastname: Hillyard
authors.forename: Rajan K
authors.initials: RK
authors.lastname: Patel
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Mark
authors.forename: Alan G
authors.initials: AG
authors.lastname: Jardine