Fibroblast growth factor 23 and markers of mineral metabolism in individuals with preserved renal function.

Details

Serval ID
serval:BIB_76C2377C0DED
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Fibroblast growth factor 23 and markers of mineral metabolism in individuals with preserved renal function.
Journal
Kidney International
Author(s)
Dhayat N.A., Ackermann D., Pruijm M., Ponte B., Ehret G., Guessous I., Leichtle A.B., Paccaud F., Mohaupt M., Fiedler G.M., Devuyst O., Pechère-Bertschi A., Burnier M., Martin P.Y., Bochud M., Vogt B., Fuster D.G.
ISSN
1523-1755 (Electronic)
ISSN-L
0085-2538
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
90
Number
3
Pages
648-657
Language
english
Abstract
Fibroblast growth factor 23 (FGF23) is a bone-derived hormone that regulates phosphate homeostasis. Circulating FGF23 is elevated in chronic kidney disease (CKD) and independently associated with poor renal and cardiovascular outcomes and mortality. Because the study of FGF23 in individuals with normal renal function has received little attention, we examined in a large, population-based study of 1128 participants the associations of FGF23 with markers of mineral metabolism and renal function. The median estimated glomerular filtration rate (eGFR) of the cohort was 105 ml/min per 1.73 m(2), and the median plasma FGF23 was 78.5 RU/ml. FGF23 increased and plasma 1,25-dihydroxyvitamin D3 decreased significantly below an eGFR threshold of 102 and 99 ml/min per 1.73 m(2), respectively. In contrast, plasma parathyroid hormone increased continuously with decreasing eGFR and was first significantly elevated at an eGFR of 126 ml/min per 1.73 m(2). On multivariable analysis adjusting for sex, age, body mass index, and GFR, FGF23 was negatively associated with 1,25-dihydroxyvitamin D3, and urinary absolute and fractional calcium excretion but not with serum calcium or parathyroid hormone. We found a positive association of FGF23 with plasma phosphate, but no association with urinary absolute or fractional phosphate excretion and, unexpectedly, a positive association with tubular maximum phosphate reabsorption/GFR. Thus, in the absence of CKD, parathyroid hormone increases earlier than FGF23 when the eGFR decreases. The increase in FGF23 occurs at a higher eGFR threshold than previously reported and is closely associated with a decrease in 1,25-dihydroxyvitamin D3. We speculate that the main demonstrable effect of FGF23 in the setting of preserved renal function is suppression of 1,25-dihydroxyvitamin D3 rather than stimulation of renal phosphate excretion.
Pubmed
Create date
02/08/2016 10:47
Last modification date
20/08/2019 15:33
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