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Nephrology Dialysis Transplantation 2005 20(3):479-482; doi:10.1093/ndt/gfh701
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Editorial Comment

The role of fibroblast growth factor 23 in renal disease

Kenneth B. Jonsson

Department of Surgical Sciences, Unit of Orthopedic Surgery, Uppsala University, Uppsala, Sweden

Correspondence and offprint requests to: Kenneth B. Jonsson, Department of Surgical Sciences, Unit of Orthopedic Surgery, Uppsala University, SE-751 85 Uppsala, Sweden. E-mail: Kenneth.jonsson@surgsci.uu.se

Keywords: CKD; ESRD; FGF23; hyperparathyroidism; hyperphosphataemia; phosphate; renal failure; vitamin D

The first 150 words of the full text of this article appear below.



   FGF23 is a phosphate regulator in physiology and pathology
 
Activating mutations in the fibroblast growth factor 23 (FGF23) gene were identified as the cause of autosomal dominant hypophosphataemic rickets (ADHR) [1]. This secreted protein was later shown to play a role in both physiological and pathological phosphate handling.

FGF23 may be the key pathogenetic molecule in three different diseases with hypophosphataemia and inappropriate regulation of vitamin D metabolism. In ADHR, the mutations stabilize the FGF23 protein, which leads to increased circulating levels [2]. In X-linked hypophosphataemia (XLH), a disease caused by inactivating mutations of the PHEX gene, the loss of a membrane-bound protease results in increased circulating levels of FGF23 [3]. Also, in the paraneoplastic syndrome of tumour-induced osteomalacia (TIO), tumours secrete large amounts of FGF23 [3–5]. Thus, in three disorders of inorganic phosphate (Pi) wasting, FGF23 circulates in increased amounts, suggesting a pathological role for the molecule.

Evidence for . . . [Full Text of this Article]



   Phosphate homeostasis and vitamin D metabolism in renal disease
 


   The role of FGF23 in the dysregluation of phosphate/calcium/vitamin D homeostasis in CKD
 
FGF23 levels are increased in renal disease
So its up, does it matter?
Are FGF23 measurements clinically useful in CKD patients?

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 Nephrol Dial TransplantHome page
R. Marsell, T. Krajisnik, H. Goransson, C. Ohlsson, O. Ljunggren, T. E. Larsson, and K. B. Jonsson
Gene expression analysis of kidneys from transgenic mice expressing fibroblast growth factor-23
Nephrol. Dial. Transplant., March 1, 2008; 23(3): 827 - 833.
[Abstract] [Full Text] [PDF]