Fibroblast Growth Factor, A Review

Excerpt

The recent identification of fibroblast growth factor (FGF)-23 has filled in the gaps of our understanding of calcium–phosphate regulation. Together with its cofactor Klotho, FGF-23 is a phosphaturic factor that influences vitamin D metabolism and renal re-absorption of phosphorus in order to maintain serum phosphate levels within the normal range. In chronic kidney disease (CKD), FGF-23 levels rise in parallel with declining kidney function before any significant rise is perceived in serum phosphate concentration. Increased serum FGF-23 levels in CKD patients were found to be independently associated with ventricular hypertrophy and endothelial dysfunction after correcting for traditional markers of calcium–phosphate metabolism. FGF-23 has been implicated in various human diseases including autosomal dominant hypophosphatemic rickets (ADHR), X-linked hypophosphatemia (XLH), tumor induced osteomalacia and familial tumoral calcinosis. Lastly, in prospective studies, elevated serum FGF-23 levels predicted rapid disease progression in non-dialysis dependent CKD patients and increased mortality in chronic hemodialysis patients. The growing knowledge and understanding of FGF-23 may provide potential answers with regards to prevention and management of CKD [1]. …