title: Serum levels of fibroblast growth factor 23 are elevated in patients with active Lupus nephritis.
abstract: Fibroblast growth factor 23 (FGF23), a phosphate-regulating hormone is an established cardiovascular risk factor. Recently, FGF23 has been related to inflammation. Lupus is an inflammatory disease, and whether FGF23 is associated with Lupus nephritis (LN) activity is unknown.
  
  
  
  We studied 15 pre-menopausal patients with recent LN diagnose (⩽2months) and compared them to 1:1 age-matched healthy control group. We measured serum levels of intact FGF23, interleukin-6 (IL-6), tumor necrosis factor α (TNFα), and urinary levels of monocyte chemotactic protein (MCP1).
  
  
  
  LN patients (29.5±10years) presented proteinuria of 4.7±2.9g/day, and estimated glomerular filtration rate of 37 (31-87)ml/min/1.73m2. They demonstrated higher FGF23 levels when compared to healthy controls [106.7 (80.3-179) vs. 33.6 (25.8-60.9) pg/ml, p<0.001]. FGF23 levels correlated with urinary MCP1 (r=0.62, p<0.001), serum TNFα (r=0.58, p<0.001) and serum IL-6 (r=0.46, p=0.01). Only the correlation between FGF23 and MCP1 remained significant after adjustments for 25(OH) vitamin D and renal function.
  
  
  
  Newly diagnosed LN patients demonstrated elevated FGF23 levels that were positively correlated to urinary MCP1, independently of vitamin D levels and kidney function. If FGF23 may predict clinical outcomes in LN warrants further evaluation.
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil.
authors.forename: Aline L
authors.initials: AL
authors.lastname: Resende
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil.
authors.forename: Rosilene M
authors.initials: RM
authors.lastname: Elias
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
authors.forename: Myles
authors.initials: M
authors.lastname: Wolf
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil.
authors.forename: Luciene M
authors.initials: LM
authors.lastname: Dos Reis
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil.
authors.forename: Fabiana G
authors.initials: FG
authors.lastname: Graciolli
authors.affiliation: Universidade Nove de Julho - UNINOVE, São Paulo, Brazil.
authors.forename: Geuza D
authors.initials: GD
authors.lastname: Santos
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil.
authors.forename: Cristiane B
authors.initials: CB
authors.lastname: Dias
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil.
authors.forename: Vanda
authors.initials: V
authors.lastname: Jorgetti
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil.
authors.forename: Viktoria
authors.initials: V
authors.lastname: Woronik
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil; Universidade Nove de Julho - UNINOVE, São Paulo, Brazil. Electronic address: rosa.moyses@uol.com.br.
authors.forename: Rosa M A
authors.initials: RM
authors.lastname: Moysés
mesh_terms: D000293:Adolescent; D000328:Adult; D018932:Chemokine CCL2 / Q000097:blood; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D008181:Lupus Nephritis / Q000097:blood* / Q000503:physiopathology; D017697:Premenopause / Q000097:blood*; D014807:Vitamin D / Q000097:blood
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; C000717427:FGF23 protein, human; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23
keywords: Cytokines; Fibroblast growth factor 23; Inflammation; Lupus nephritis; Monocyte chemotactic protein-1; Systemic lupus erythematosus