title: FGF-23: the rise of a novel cardiovascular risk marker in CKD.
abstract: Elevated plasma levels of the phosphaturic hormone fibroblast growth factor 23 (FGF-23) are a hallmark of chronic kidney disease (CKD)-mineral and bone disorder. FGF-23 allows serum phosphate levels within physiological limits to be maintained in progressive CKD until end-stage renal disease is reached. Despite its seemingly beneficial role in phosphate homeostasis, several prospective studies in dialysis patients and in patients with less advanced CKD associated elevated FGF-23 with poor cardiovascular and renal outcome. Moreover, very recent evidence suggests an adverse prognostic impact of elevated FGF-23 even in subjects without manifest CKD. These epidemiological data are supplemented by laboratory findings that reveal a pathophysiological role of FGF-23 in the pathogenesis of myocardial injury. In aggregate, these clinical and experimental data identify FGF-23 as a promising target of novel therapeutic interventions in CKD and beyond, which should be tested in future clinical trials.
authors.affiliation: Department of Internal Medicine IV—Nephrology and Hypertension, Saarland University Medical Center, Homburg/Saar, Germany. Gunnar.Heine@uks.eu
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Heine
authors.forename: Sarah
authors.initials: S
authors.lastname: Seiler
authors.forename: Danilo
authors.initials: D
authors.lastname: Fliser
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism*; D018450:Disease Progression; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism*; D006801:Humans; D008954:Models, Biological; D010710:Phosphates / Q000378:metabolism; D010760:Phosphorus Metabolism Disorders / Q000209:etiology / Q000378:metabolism; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000378:metabolism*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D010710:Phosphates; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002118:Calcium