Elevated Fibroblast Growth Factor 23 Concentration: Prediction of Mortality among Chronic Kidney Disease Patients
Background: The osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D production, thereby mitigating hyperphosphatemia in patients with renal disorders. An elevated FGF23 level is suggested to be an early biomarker...
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| Published in | Cardiorenal medicine Vol. 6; no. 1; pp. 73 - 82 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Basel, Switzerland
S. Karger AG
01.12.2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1664-3828 1664-5502 |
| DOI | 10.1159/000440984 |
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| Abstract | Background: The osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D production, thereby mitigating hyperphosphatemia in patients with renal disorders. An elevated FGF23 level is suggested to be an early biomarker of altered phosphorus metabolism in the initial stages of chronic kidney disease (CKD) and acts as a strong predictor of mortality in dialysis patients. In the Saudi population, there is no report on the FGF23 level in CKD patients to date. This study aims to estimate the plasma FGF23 levels in the Saudi population and to correlate it with its clinical manifestations in order to ascertain its role in the pathogenesis of CKD patients. Methods: The FGF23 level in the plasma samples was determined using ELISA in a diverse cohort of 89 cases with stage 3-5 CKD and 100 healthy subjects. The plasma FGF23 level was correlated with other biochemical parameters. Results: The results revealed that the FGF23 level was markedly elevated among CKD patients compared to the control group, and a significant inverse correlation was observed between the FGF23 level and glomerular filtration rate. FGF23 elevation was approximately 40-fold among stage 5 patients compared to the control, while the elevation of phosphate, parathyroid hormone (PTH) and alkaline phosphatase was 2-, 3- and 8-fold in this stage, respectively. Conclusion: Elevated FGF23 levels may have a strong correlation with the disease pathogenesis. In addition, FGF23 might be a future therapeutic target to intervene against the progression of CKD as well as to increase patient survivability. |
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| AbstractList | The osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D production, thereby mitigating hyperphosphatemia in patients with renal disorders. An elevated FGF23 level is suggested to be an early biomarker of altered phosphorus metabolism in the initial stages of chronic kidney disease (CKD) and acts as a strong predictor of mortality in dialysis patients. In the Saudi population, there is no report on the FGF23 level in CKD patients to date. This study aims to estimate the plasma FGF23 levels in the Saudi population and to correlate it with its clinical manifestations in order to ascertain its role in the pathogenesis of CKD patients.
The FGF23 level in the plasma samples was determined using ELISA in a diverse cohort of 89 cases with stage 3-5 CKD and 100 healthy subjects. The plasma FGF23 level was correlated with other biochemical parameters.
The results revealed that the FGF23 level was markedly elevated among CKD patients compared to the control group, and a significant inverse correlation was observed between the FGF23 level and glomerular filtration rate. FGF23 elevation was approximately 40-fold among stage 5 patients compared to the control, while the elevation of phosphate, parathyroid hormone (PTH) and alkaline phosphatase was 2-, 3- and 8-fold in this stage, respectively.
Elevated FGF23 levels may have a strong correlation with the disease pathogenesis. In addition, FGF23 might be a future therapeutic target to intervene against the progression of CKD as well as to increase patient survivability. BACKGROUNDThe osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D production, thereby mitigating hyperphosphatemia in patients with renal disorders. An elevated FGF23 level is suggested to be an early biomarker of altered phosphorus metabolism in the initial stages of chronic kidney disease (CKD) and acts as a strong predictor of mortality in dialysis patients. In the Saudi population, there is no report on the FGF23 level in CKD patients to date. This study aims to estimate the plasma FGF23 levels in the Saudi population and to correlate it with its clinical manifestations in order to ascertain its role in the pathogenesis of CKD patients.METHODSThe FGF23 level in the plasma samples was determined using ELISA in a diverse cohort of 89 cases with stage 3-5 CKD and 100 healthy subjects. The plasma FGF23 level was correlated with other biochemical parameters.RESULTSThe results revealed that the FGF23 level was markedly elevated among CKD patients compared to the control group, and a significant inverse correlation was observed between the FGF23 level and glomerular filtration rate. FGF23 elevation was approximately 40-fold among stage 5 patients compared to the control, while the elevation of phosphate, parathyroid hormone (PTH) and alkaline phosphatase was 2-, 3- and 8-fold in this stage, respectively.CONCLUSIONElevated FGF23 levels may have a strong correlation with the disease pathogenesis. In addition, FGF23 might be a future therapeutic target to intervene against the progression of CKD as well as to increase patient survivability. Background: The osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D production, thereby mitigating hyperphosphatemia in patients with renal disorders. An elevated FGF23 level is suggested to be an early biomarker of altered phosphorus metabolism in the initial stages of chronic kidney disease (CKD) and acts as a strong predictor of mortality in dialysis patients. In the Saudi population, there is no report on the FGF23 level in CKD patients to date. This study aims to estimate the plasma FGF23 levels in the Saudi population and to correlate it with its clinical manifestations in order to ascertain its role in the pathogenesis of CKD patients. Methods: The FGF23 level in the plasma samples was determined using ELISA in a diverse cohort of 89 cases with stage 3-5 CKD and 100 healthy subjects. The plasma FGF23 level was correlated with other biochemical parameters. Results: The results revealed that the FGF23 level was markedly elevated among CKD patients compared to the control group, and a significant inverse correlation was observed between the FGF23 level and glomerular filtration rate. FGF23 elevation was approximately 40-fold among stage 5 patients compared to the control, while the elevation of phosphate, parathyroid hormone (PTH) and alkaline phosphatase was 2-, 3- and 8-fold in this stage, respectively. Conclusion: Elevated FGF23 levels may have a strong correlation with the disease pathogenesis. In addition, FGF23 might be a future therapeutic target to intervene against the progression of CKD as well as to increase patient survivability. |
| Author | Al Ali, Amein Al-Nafaie, Awatif Al-Mueilo, Samir Chathoth, Shahanas Vatte, Chittibabu Al-Ali, Rudaynah Al-Muhanna, Fahad Cyrus, Cyril Keating, Brendan J. |
| AuthorAffiliation | b King Fahd Hospital of the University (KFHU), Al-Khobar, Saudi Arabia a Center for Research and Medical Consultation, University of Dammam, Dammam, Saudi Arabia c Division of Transplantation, Department of Surgery, University of Pennsylvania, Philadelphia, Pa., USA |
| AuthorAffiliation_xml | – name: a Center for Research and Medical Consultation, University of Dammam, Dammam, Saudi Arabia – name: c Division of Transplantation, Department of Surgery, University of Pennsylvania, Philadelphia, Pa., USA – name: b King Fahd Hospital of the University (KFHU), Al-Khobar, Saudi Arabia |
| Author_xml | – sequence: 1 givenname: Shahanas surname: Chathoth fullname: Chathoth, Shahanas email: schathoth@ud.edu.sa – sequence: 2 givenname: Samir surname: Al-Mueilo fullname: Al-Mueilo, Samir – sequence: 3 givenname: Cyril surname: Cyrus fullname: Cyrus, Cyril – sequence: 4 givenname: Chittibabu surname: Vatte fullname: Vatte, Chittibabu – sequence: 5 givenname: Awatif surname: Al-Nafaie fullname: Al-Nafaie, Awatif – sequence: 6 givenname: Rudaynah surname: Al-Ali fullname: Al-Ali, Rudaynah – sequence: 7 givenname: Brendan J. surname: Keating fullname: Keating, Brendan J. – sequence: 8 givenname: Fahad surname: Al-Muhanna fullname: Al-Muhanna, Fahad – sequence: 9 givenname: Amein surname: Al Ali fullname: Al Ali, Amein |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27194998$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1172/JCI32409 10.1001/jama.2011.826 10.1093/ije/dyh132 10.1681/ASN.2006080936 10.1097/MNH.0b013e328331a8c8 10.1056/NEJMoa020881 10.1681/ASN.2005111185 10.1038/ki.2012.327 10.1152/ajprenal.00360.2010 10.1056/NEJMoa0706130 10.1007/978-1-4614-0887-1_2 10.2215/CJN.10941013 10.1186/s13054-015-0925-6 10.1093/ndt/gfp191 10.1007/s11255-013-0386-2 10.1159/000365787 10.1111/j.1523-1755.2005.00178.x 10.2215/CJN.10331011 10.1093/eurheartj/eht571 10.1681/ASN.2009121293 10.2478/v10011-011-0031-5 10.1159/000368468 10.1186/1471-2369-13-20 10.1007/s00198-014-2862-7 10.1093/ndt/gfq191 |
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| Copyright | 2015 S. Karger AG, Basel Copyright S. Karger AG Dec 2015 Copyright © 2015 by S. Karger AG, Basel 2015 |
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| Keywords | Chronic kidney disease Parathyroid hormone FGF23 Mortality Phosphate Calcitriol |
| Language | English |
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| References | Wolf M: Fibroblast growth factor 23 and the future of phosphorus management. Curr Opin Nephrol Hypertens 2009;18:463-468.1977075610.1097/MNH.0b013e328331a8c8 Jean G, Terrat JC, Vanel T, Hurot JM, Lorriaux C, Mayor B, Chazot C: High levels of serum fibroblast growth factor (FGF)-23 are associated with increased mortality in long haemodialysis patients. Nephrol Dial Transplant 2009;24:2792-2796.1939573010.1093/ndt/gfp191 Smith GD, Ebrahim S: Mendelian randomization prospects, potentials, and limitations. Int J Epidemiol 2004;33:30-42.1507514310.1093/ije/dyh132 Zhang LN, Yang G, Cheng C, Shen C, Cui YY, Zhang J, et al: Plasma FGF23 levels and heart rate variability in patients with stage 5 CKD. Osteoporos Int 2015;26:395-405.2522429210.1007/s00198-014-2862-7 Sugimoto H, Ogawa T, Iwabuchi Y, Otsuka K, Nitta K: Relationship between serum fibroblast growth factor-23 level and mortality in chronic hemodialysis patients. Int Urol Nephrol 2014;46:99-106.2335502910.1007/s11255-013-0386-2 Elsammak MY, Attia A, Suleman M: Fibroblast growth factor-23 and hypophosphatemia in chronic obstructive pulmonary disease patients. J Med Biochem 2012;31:12-18.10.2478/v10011-011-0031-5 Lavi-Moshayoff V, Wasserman G, Meir T, Silver J, Naveh-Many T: PTH increases FGF23 gene expression and mediates the high FGF23 levels of experimental kidney failure: a bone parathyroid feedback loop. Am J Physiol Renal Physiol 2010;299:F882-F889.2068582310.1152/ajprenal.00360.2010 Wolf M: Forging forward with 10 burning questions on FGF23 in kidney disease. J Am Soc Nephrol 2010;21:1427-1435.2050794310.1681/ASN.2009121293 Ärnlöv J, Carlsson AC, Sundström J, Ingelsson E, Larsson A, Lind L, Larsson TE: Higher fibroblast growth factor-23 increases the risk of all cause and cardiovascular mortality in the community. 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J Am Soc Nephrol 2007;18:2600-2608.1765647910.1681/ASN.2006080936 Vervloet MG, van Zuilen AD, Heijboer AC, ter Wee PM, Bots ML, Blankestijn PJ, Wetzels JF; MASTERPLAN group study: fibroblast growth factor 23 is associated with proteinuria and smoking in chronic kidney disease: an analysis of the MASTERPLAN cohort. BMC Nephrol 2012;13:20.2253096610.1186/1471-2369-13-20 Gutiérrez OM, Mannstadt M, Isakova T, Rauh-Hain JA, Tamez H, Shah A, Smith K, Lee H, Thadhani R, Jüppner H, Wolf M: Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis. 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| References_xml | – reference: Ärnlöv J, Carlsson AC, Sundström J, Ingelsson E, Larsson A, Lind L, Larsson TE: Higher fibroblast growth factor-23 increases the risk of all cause and cardiovascular mortality in the community. Kidney Int 2013;83:160-166.2295189010.1038/ki.2012.327 – reference: Lavi-Moshayoff V, Wasserman G, Meir T, Silver J, Naveh-Many T: PTH increases FGF23 gene expression and mediates the high FGF23 levels of experimental kidney failure: a bone parathyroid feedback loop. Am J Physiol Renal Physiol 2010;299:F882-F889.2068582310.1152/ajprenal.00360.2010 – reference: Jean G, Terrat JC, Vanel T, Hurot JM, Lorriaux C, Mayor B, Chazot C: High levels of serum fibroblast growth factor (FGF)-23 are associated with increased mortality in long haemodialysis patients. Nephrol Dial Transplant 2009;24:2792-2796.1939573010.1093/ndt/gfp191 – reference: Elsammak MY, Attia A, Suleman M: Fibroblast growth factor-23 and hypophosphatemia in chronic obstructive pulmonary disease patients. 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| Snippet | Background: The osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D... The osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D production,... BACKGROUNDThe osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D... |
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| Title | Elevated Fibroblast Growth Factor 23 Concentration: Prediction of Mortality among Chronic Kidney Disease Patients |
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