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Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease.

Publication ,  Journal Article
Isakova, T; Wahl, P; Vargas, GS; Gutiérrez, OM; Scialla, J; Xie, H; Appleby, D; Nessel, L; Bellovich, K; Chen, J; Hamm, L; Gadegbeku, C ...
Published in: Kidney Int
June 2011

Fibroblast growth factor 23 (FGF23) regulates phosphorus metabolism and is a strong predictor of mortality in dialysis patients. FGF23 is thought to be an early biomarker of disordered phosphorus metabolism in the initial stages of chronic kidney disease (CKD). We measured FGF23 in baseline samples from 3879 patients in the Chronic Renal Insufficiency Cohort study, which is a diverse cohort of patients with CKD stage 2-4. Mean serum phosphate and median parathyroid hormone (PTH) levels were in the normal range, but median FGF23 was markedly greater than in healthy populations, and increased significantly with decreasing estimated glomerular filtration rate (eGFR). High levels of FGF23, defined as being above 100 RU/ml, were more common than secondary hyperparathyroidism and hyperphosphatemia in all strata of eGFR. The threshold of eGFR at which the slope of FGF23 increased was significantly higher than the corresponding threshold for PTH based on non-overlapping 95% confidence intervals. Thus, increased FGF23 is a common manifestation of CKD that develops earlier than increased phosphate or PTH. Hence, FGF23 measurements may be a sensitive early biomarker of disordered phosphorus metabolism in patients with CKD and normal serum phosphate levels.

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Published In

Kidney Int

DOI

EISSN

1523-1755

Publication Date

June 2011

Volume

79

Issue

12

Start / End Page

1370 / 1378

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Up-Regulation
  • United States
  • Time Factors
  • Severity of Illness Index
  • Renal Insufficiency, Chronic
  • Prospective Studies
  • Predictive Value of Tests
  • Phosphorus, Dietary
  • Phosphates
 

Citation

APA
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ICMJE
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Isakova, T., Wahl, P., Vargas, G. S., Gutiérrez, O. M., Scialla, J., Xie, H., … Wolf, M. (2011). Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int, 79(12), 1370–1378. https://doi.org/10.1038/ki.2011.47
Isakova, Tamara, Patricia Wahl, Gabriela S. Vargas, Orlando M. Gutiérrez, Julia Scialla, Huiliang Xie, Dina Appleby, et al. “Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease.Kidney Int 79, no. 12 (June 2011): 1370–78. https://doi.org/10.1038/ki.2011.47.
Isakova T, Wahl P, Vargas GS, Gutiérrez OM, Scialla J, Xie H, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011 Jun;79(12):1370–8.
Isakova, Tamara, et al. “Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease.Kidney Int, vol. 79, no. 12, June 2011, pp. 1370–78. Pubmed, doi:10.1038/ki.2011.47.
Isakova T, Wahl P, Vargas GS, Gutiérrez OM, Scialla J, Xie H, Appleby D, Nessel L, Bellovich K, Chen J, Hamm L, Gadegbeku C, Horwitz E, Townsend RR, Anderson CAM, Lash JP, Hsu C-Y, Leonard MB, Wolf M. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011 Jun;79(12):1370–1378.
Journal cover image

Published In

Kidney Int

DOI

EISSN

1523-1755

Publication Date

June 2011

Volume

79

Issue

12

Start / End Page

1370 / 1378

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Up-Regulation
  • United States
  • Time Factors
  • Severity of Illness Index
  • Renal Insufficiency, Chronic
  • Prospective Studies
  • Predictive Value of Tests
  • Phosphorus, Dietary
  • Phosphates