Fibroblast growth factor 23: are we ready to use it in clinical practice?

Journal of Nephrology
Annet Bouma-de Krijger, Marc G Vervloet

Abstract

Patients with chronic kidney disease (CKD) have a greatly enhanced risk of cardiovascular morbidity and mortality. Over the past decade it has come clear that a disturbed calcium-phosphate metabolism, with Fibroblast Growth Factor-23 as a key hormone, is partly accountable for this enhanced risk. Numerous studies have been performed unravelling FGF23s actions and its association with clinical conditions. As FGF23 is strongly associated with adverse outcome it may be a promising biomarker for risk prediction or, even more important, targeting FGF23 may be a strategy to improve patient outcome. This review elaborates on the clinical usefulness of FGF23 measurement. Firstly it discusses the reliability of the FGF23 measurement. Secondly, it evaluates whether FGF23 measurement may lead to improved patient risk classification. Finally, and possibly most importantly, this review evaluates if lowering of FGF23 should be a target for therapy. For this, the review discusses the current evidence indicating that FGF23 may be in the causal pathway to cardiovascular pathology, provides an overview of strategies to lower FGF23 levels and discusses the current evidence concerning the benefit of lowering FGF23.

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Citations

Jun 9, 2020·The Journal of Clinical Endocrinology and Metabolism·Jelmer K HumaldaMartin H de Borst
Jan 21, 2021·American Journal of Hematology·Kamyar Kalantar-ZadehMichael A Levine
Jan 30, 2021·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Ebru AsiciogluCetin Ozener
Jun 1, 2021·Disease Markers·Anna KurpasMarzenna Zielińska
Jul 21, 2021·Clinical Science·Amarens van der VaartMartin H de Borst
Aug 12, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Edith H Svensson, Martin Söderholm

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