Relationship between Fibroblast Growth Factor-23 and Mineral Metabolism in Chronic Kidney Disease

Fibroblast growth factor- (FGF-)23 is a recently discovered regulator of calcium-phosphate metabolism. FGF-23 appears to decrease in synthesis and accelerated degradation of 1,25(OH)2D. Together with its cofactor Klotho, FGF-23 maintains serum phosphate levels within the normal range by increasing r...

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Main Author: Kosaku Nitta
Format: Article
Language:English
Published: Wiley 2010-01-01
Series:International Journal of Nephrology
Online Access:http://dx.doi.org/10.4061/2010/167984
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author Kosaku Nitta
author_facet Kosaku Nitta
author_sort Kosaku Nitta
collection DOAJ
description Fibroblast growth factor- (FGF-)23 is a recently discovered regulator of calcium-phosphate metabolism. FGF-23 appears to decrease in synthesis and accelerated degradation of 1,25(OH)2D. Together with its cofactor Klotho, FGF-23 maintains serum phosphate levels within the normal range by increasing renal phosphate excretion. In chronic kidney disease (CKD), FGF-23 levels rise in parallel with the decline in renal function long before a significant increase in serum phosphate concentration occurs. Both Klotho and FGF-23, linked by a receptor mechanism, affect vitamin D synthesis and parathyroid hormone (PTH) secretion. Previous studies have shown a close association between reduced FGF-23 or Klotho activities and vascular calcification. The possible association of FGF-23 and left ventricular hypertrophy or vascular dysfunction has been proposed. Finally, prospective studies have shown that high serum FGF-23 concentrations predict more rapid disease progression in CKD patients who were not on dialysis and increased mortality in patients on maintenance hemodialysis. FGF-23 may therefore prove to be an important therapeutic target for the management of CKD.
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spelling doaj-art-354eb16facb04e3ab331477b0a58cfdb2025-02-03T05:50:07ZengWileyInternational Journal of Nephrology2090-21582010-01-01201010.4061/2010/167984167984Relationship between Fibroblast Growth Factor-23 and Mineral Metabolism in Chronic Kidney DiseaseKosaku Nitta0Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanFibroblast growth factor- (FGF-)23 is a recently discovered regulator of calcium-phosphate metabolism. FGF-23 appears to decrease in synthesis and accelerated degradation of 1,25(OH)2D. Together with its cofactor Klotho, FGF-23 maintains serum phosphate levels within the normal range by increasing renal phosphate excretion. In chronic kidney disease (CKD), FGF-23 levels rise in parallel with the decline in renal function long before a significant increase in serum phosphate concentration occurs. Both Klotho and FGF-23, linked by a receptor mechanism, affect vitamin D synthesis and parathyroid hormone (PTH) secretion. Previous studies have shown a close association between reduced FGF-23 or Klotho activities and vascular calcification. The possible association of FGF-23 and left ventricular hypertrophy or vascular dysfunction has been proposed. Finally, prospective studies have shown that high serum FGF-23 concentrations predict more rapid disease progression in CKD patients who were not on dialysis and increased mortality in patients on maintenance hemodialysis. FGF-23 may therefore prove to be an important therapeutic target for the management of CKD.http://dx.doi.org/10.4061/2010/167984
spellingShingle Kosaku Nitta
Relationship between Fibroblast Growth Factor-23 and Mineral Metabolism in Chronic Kidney Disease
International Journal of Nephrology
title Relationship between Fibroblast Growth Factor-23 and Mineral Metabolism in Chronic Kidney Disease
title_full Relationship between Fibroblast Growth Factor-23 and Mineral Metabolism in Chronic Kidney Disease
title_fullStr Relationship between Fibroblast Growth Factor-23 and Mineral Metabolism in Chronic Kidney Disease
title_full_unstemmed Relationship between Fibroblast Growth Factor-23 and Mineral Metabolism in Chronic Kidney Disease
title_short Relationship between Fibroblast Growth Factor-23 and Mineral Metabolism in Chronic Kidney Disease
title_sort relationship between fibroblast growth factor 23 and mineral metabolism in chronic kidney disease
url http://dx.doi.org/10.4061/2010/167984
work_keys_str_mv AT kosakunitta relationshipbetweenfibroblastgrowthfactor23andmineralmetabolisminchronickidneydisease