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Fibroblast growth factor 23: associations with cardiovascular disease and mortality in chronic kidney disease.
MedLine Citation:
PMID:  23296792     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Fibroblast growth factor-23 (FGF-23) has emerged as an important hormone involved in phosphorus and vitamin D homeostasis. Chronic kidney disease (CKD) is the most common clinical condition in which FGF-23 levels are persistently and markedly elevated. Abnormal phosphate homeostasis and high circulating levels of FGF-23 are early complications of CKD. Although increases in FGF-23 levels may help maintain serum phosphate levels in the normal range in CKD, the long-term effects of its sustained elevated levels are unclear. Patients with CKD have high risks of developing end-stage renal disease (ESRD), cardiovascular disease, and premature death. Recent prospective studies in populations with predialysis CKD, ESRD on hemodialysis, and kidney transplant recipients demonstrate that elevated FGF-23 levels are independently associated with cardiovascular events and mortality. It was originally thought that FGF-23 was only a biomarker of disturbed phosphate balance; however, recent studies have shown that FGF-23 can have a direct effect on the heart, inducing left ventricular hypertrophy. This suggests that elevated FGF-23 levels may be a novel mechanism that explains the poor cardiovascular outcomes in CKD patients. Interventional studies are required in order to clarify the relation of causality between FGF-23 and cardiovascular mortality in this population.
Authors:
Armando Luis Negri
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-8
Journal Detail:
Title:  International urology and nephrology     Volume:  -     ISSN:  1573-2584     ISO Abbreviation:  Int Urol Nephrol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Facultad de Medicina, Instituto de Investigaciones Metabólicas, Universidad del Salvador, Libertad 836 1 piso, 1012, Buenos Aires, Argentina, negri@casasco.com.ar.
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