title: Interorgan handling of fibroblast growth factor-23 in humans.
abstract: Fibroblast growth factor-23 (FGF-23) accumulates in blood of patients with chronic kidney disease (CKD) and is associated both with cardiovascular complications and disease progression. However, our knowledge of the sites and mechanisms that regulate plasma FGF-23 is still incomplete. We measured plasma intact FGF-23 across the kidney, splanchnic organs, and lung in 11 patients [estimated glomerular filtration rate (eGFR) 60 ± 6 ml/min] during elective diagnostic cardiac catheterizations. In these patients FGF-23 was removed by the kidney, with a fractional extraction (FE) of ∼22%. The FE of FGF-23 across the kidney was similar to that of creatinine (∼17%, P = NS). In addition, the FGF-23 FE by the kidney was significantly directly related to eGFR (r = 0.709 P = 0.018) and to kidney creatinine FE (r = 0.736 P = 0.013) but only as a trend to plasma phosphate levels (r = 0.55, P = 0.18). There was no difference in FGF-23 levels in blood perfusing splanchnic organs and cardiopulmonary bed. However, the arterial-venous difference of FGF-23 across the lung was directly related to FGF-23 pulmonary artery levels, suggesting that the lung, and possibly the heart, participate in the homeostasis of plasma FGF-23 when its systemic levels are increased. Our data show that the human kidney is the only site for FGF-23 removal from blood and suggest that FGF-23 is predominantly removed by glomerular filtration. The kidney ability to remove FGF-23 from the circulation likely accounts for the early increase in blood of FGF-23 in patients with CKD.
authors: Department of Internal Medicine, Clinica Nefrologica Dialisi e Trapianto, Genoa University and Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria (IRCCS AOU) San Martino-Istituto Tumori (IST), Genoa, Italy; and.
authors: Daniela
authors: D
authors: Verzola
authors: Department of Internal Medicine, Clinica Nefrologica Dialisi e Trapianto, Genoa University and Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria (IRCCS AOU) San Martino-Istituto Tumori (IST), Genoa, Italy; and.
authors: Francesca
authors: F
authors: Ansaldo
authors: Department of Internal Medicine, Clinica Nefrologica Dialisi e Trapianto, Genoa University and Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria (IRCCS AOU) San Martino-Istituto Tumori (IST), Genoa, Italy; and.
authors: Samantha
authors: S
authors: Milanesi
authors: Department of Internal Medicine, Clinica Nefrologica Dialisi e Trapianto, Genoa University and Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria (IRCCS AOU) San Martino-Istituto Tumori (IST), Genoa, Italy; and.
authors: Emanuele Luigi
authors: EL
authors: Parodi
authors: Clinica delle Malattia Cardiovascolari, Genoa University and IRCCS AOU San Martino-IST, Genoa, Italy.
authors: Gian Marco
authors: GM
authors: Rosa
authors: Department of Internal Medicine, Clinica Nefrologica Dialisi e Trapianto, Genoa University and Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria (IRCCS AOU) San Martino-Istituto Tumori (IST), Genoa, Italy; and.
authors: Antonella
authors: A
authors: Sofia
authors: Department of Internal Medicine, Clinica Nefrologica Dialisi e Trapianto, Genoa University and Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria (IRCCS AOU) San Martino-Istituto Tumori (IST), Genoa, Italy; and.
authors: Alice
authors: A
authors: Bonanni
authors: Department of Internal Medicine, Clinica Nefrologica Dialisi e Trapianto, Genoa University and Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria (IRCCS AOU) San Martino-Istituto Tumori (IST), Genoa, Italy; and.
authors: Francesca
authors: F
authors: Viazzi
authors: Clinica delle Malattia Cardiovascolari, Genoa University and IRCCS AOU San Martino-IST, Genoa, Italy.
authors: Manrico
authors: M
authors: Balbi
authors: Department of Internal Medicine, Clinica Nefrologica Dialisi e Trapianto, Genoa University and Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria (IRCCS AOU) San Martino-Istituto Tumori (IST), Genoa, Italy; and gari@unige.it.
authors: Giacomo
authors: http://orcid.org/0000-0001-6432-2429
authors: G
authors: Garibotto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007668:Kidney / Q000378:metabolism*; D008168:Lung / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000378:metabolism*; D013152:Splanchnic Circulation / Q000502:physiology*
chemical_list: C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23
keywords: CKD; FGF-23; phosphate