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NDT Advance Access originally published online on July 31, 2008
Nephrology Dialysis Transplantation 2008 23(11):3391-3393; doi:10.1093/ndt/gfn438
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


PTH, FGF-23 and early CKD*

Mariano Rodriguez1 and Arnold J. Felsenfeld2

1 Unidad de Investigación, Servicio de Nefrologia, Hospital Universitario Reina Sofia, Cordoba, Spain 2 Department of Medicine, West Los Angeles VA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

Correspondence and offprint requests to: Mariano Rodriguez, Unidad de Investigación, Hospital Universitario Reina Sofia, Avd Menendez Pidal s/n Cordoba 14004. Tel: +34-957-011040; Fax: +34-957-010452; E-mail: juanm.rodriguez.sspa@juntadeandalucia.es

Keywords: calcium; CKD; FGF-23; phosphate; PTH

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   Introduction
 
Patients with early CKD (GFR > 30 ml/min per 1.73 m2) do not usually have changes in the serum calcium and phosphate concentration. PTH may be minimally increased and more recent publications have shown that the phosphaturic hormone, FGF-23, is clearly increased. Thus in early CKD, serum levels of phosphate and calcium are maintained within normal levels because hormonal changes compensate for the decrease in GFR. The aim of the study by Isakova et al. [1] was to analyze postprandial changes in serum calcium and phosphate which may serve as an intermittent stimulus for PTH and FGF-23 production. The study included 21 healthy volunteers and 13 CKD patients with a mean GFR of 41 ± 8 ml/min per m2 and normal serum levels of calcium, phosphate and PTH. In the fasting state, CKD patients had significantly higher levels of FGF-23, a higher fractional excretion of phosphate (FEPO4. . . [Full Text of this Article]



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