title: Fibroblast growth factor 23 in untreated nephrotic syndrome.
abstract: OBJECTIVE
  Despite its importance in bone and cardiovascular disease in subjects with kidney disease, there are no data on fibroblast growth factor 23 (FGF23) perturbations in nephrotic syndrome. We evaluated FGF23 and markers of mineral bone metabolism in subjects with untreated NS.
  
  
  METHODS
  In this cross-sectional study, we measured circulating levels of FGF23, 25-hydroxy vitamin D [25(OH)D], 1,25 di-hydroxy vitamin D [1,25(OH)2D], serum albumin, serum calcium, phosphorus, creatinine and intact parathyroid hormone (iPTH) in 101 patients with adults onset NS and 40 healthy controls. We examined the correlation between FGF23 and markers of mineral bone metabolism.
  
  
  RESULTS
  Compared to healthy controls, subjects with NS showed reduced levels of 25(OH)D (21.76 ± 10.18 vs 35.74 ± 40.27 nmol/L, P = 0.001), 1,25(OH)2D (median; 37.80 vs 73.13 pmol/L, P = 0.0001) and FGF23 (37.81 ± 20.42 vs 48.20 ± 11.60 pg/mL, P = 0.004) levels. Serum phosphorus levels were marginally, but significantly higher in subjects with nephrotic syndrome compared to healthy controls (P = 0.004). Serum iPTH levels were significantly higher in subjects with NS compared to healthy controls (52.24 ± 39.58 vs 37.90 ± 14.60 pg/mL, P = 0.028).
  
  
  CONCLUSIONS
  We conclude that FGF23 is reduced in subjects with NS compared to healthy controls. The reduced levels of Vitamin D, and urinary losses may contribute to lower levels of FGF23 in NS.
authors.affiliation: Department of Nephrology, Chandigarh, India.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Yadav
authors.affiliation: Department of Nephrology, Chandigarh, India.
authors.forename: Raja
authors.initials: R
authors.lastname: Ramachandran
authors.affiliation: Department of Internal Medicine and Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Nephrology, Chandigarh, India.
authors.forename: Vinod
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Nephrology, Chandigarh, India.
authors.forename: Krishan Lal
authors.initials: KL
authors.lastname: Gupta
authors.affiliation: Department of Nephrology, Chandigarh, India.|George Institute for Global Health, 219-221 Splendor Forum, New Delhi.
authors.forename: Vivekanand
authors.initials: V
authors.lastname: Jha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000097:blood* / Q000175:diagnosis; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D000075462:Serum Albumin, Human / Q000032:analysis; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; C470125:PTH protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D005346:Fibroblast Growth Factors; C097949:1,25-dihydroxyvitamin D; D000089703:Fibroblast Growth Factor-23; C104450:25-hydroxyvitamin D; D003404:Creatinine; D002118:Calcium; D000075462:Serum Albumin, Human
keywords: FGF23; Nephrotic syndrome; Vitamin D