title: Fibroblast growth factor 23 and adverse clinical outcomes in chronic kidney disease.
abstract: OBJECTIVE
  The aim is to review data on the epidemiology of fibroblast growth factor 23 (FGF23) and adverse clinical outcomes in chronic kidney disease (CKD) and introduce recent insights into the pathophysiology behind the observed relationships.
  
  
  RESULTS
  End-stage renal disease and cardiovascular disease are frequent events in patients with CKD, in whom cardiovascular disease is the leading cause of death. Elevated levels of FGF23, a phosphate and vitamin D-regulating hormone, have been associated with risks of end-stage renal disease, cardiovascular disease and mortality. FGF23 excess has also been linked with left-ventricular hypertrophy, and innovative translational experiments have recently established direct end-organ toxicity of FGF23, which induced left-ventricular hypertrophy in animals.
  
  
  CONCLUSIONS
  FGF23 is emerging as a novel risk factor in CKD. Future studies should determine whether interventions that lower FGF23 levels improve clinical outcomes in CKD.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Florida 33136, USA. tisakova@med.miami.edu
authors.forename: Tamara
authors.initials: T
authors.lastname: Isakova
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality; D002908:Chronic Disease; D018450:Disease Progression; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23