Nephro-Urology Monthly

Published by: Kowsar

The Association of Fibroblast Growth Factor-23 with Mineral Factors (Ca, P, and Mg), Parathyroid Hormone, and 25-Hydroxyvitamin D in Hemodialysis Patients: A Multicenter Study

Farzanehsadat Minoo 1 , 2 , Elham Ramezanzade 3 , * , Mehrzad Mojarad 1 , Azam Alamdari 1 , 2 and Mohammad Taghi Najafi 1 , 2
Authors Information
1 Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 Center of Excellence in Nephrology, Tehran University of Medical Sciences, Tehran, Iran
3 Organ Transplantation Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Article information
  • Nephro-Urology Monthly: November 2018, 10 (6); e84296
  • Published Online: November 5, 2018
  • Article Type: Research Article
  • Received: September 15, 2018
  • Accepted: October 7, 2018
  • DOI: 10.5812/numonthly.84296

To Cite: Minoo F, Ramezanzade E, Mojarad M, Alamdari A, Najafi M T. The Association of Fibroblast Growth Factor-23 with Mineral Factors (Ca, P, and Mg), Parathyroid Hormone, and 25-Hydroxyvitamin D in Hemodialysis Patients: A Multicenter Study, Nephro-Urol Mon. 2018 ; 10(6):e84296. doi: 10.5812/numonthly.84296.

Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Coresh J, Turin TC, Matsushita K, Sang Y, Ballew SH, Appel LJ, et al. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality. JAMA. 2014;311(24):2518-31. doi: 10.1001/jama.2014.6634. [PubMed: 24892770]. [PubMed Central: PMC4172342].
  • 2. Schnedl C, Fahrleitner-Pammer A, Pietschmann P, Amrein K. FGF23 in acute and chronic illness. Dis Markers. 2015;2015:358086. doi: 10.1155/2015/358086. [PubMed: 26491212]. [PubMed Central: PMC4600945].
  • 3. Scialla JJ, Xie H, Rahman M, Anderson AH, Isakova T, Ojo A, et al. Fibroblast growth factor-23 and cardiovascular events in CKD. J Am Soc Nephrol. 2014;25(2):349-60. doi: 10.1681/ASN.2013050465. [PubMed: 24158986]. [PubMed Central: PMC3904568].
  • 4. Park M, Shlipak MG, Katz R, Agarwal S, Ix JH, Hsu CY, et al. Subclinical cardiac abnormalities and kidney function decline: The multi-ethnic study of atherosclerosis. Clin J Am Soc Nephrol. 2012;7(7):1137-44. doi: 10.2215/CJN.01230212. [PubMed: 22580783]. [PubMed Central: PMC3386670].
  • 5. Lundberg S, Qureshi AR, Olivecrona S, Gunnarsson I, Jacobson SH, Larsson TE. FGF23, albuminuria, and disease progression in patients with chronic IgA nephropathy. Clin J Am Soc Nephrol. 2012;7(5):727-34. doi: 10.2215/CJN.10331011. [PubMed: 22383747]. [PubMed Central: PMC3338280].
  • 6. Isakova T, Xie H, Yang W, Xie D, Anderson AH, Scialla J, et al. Fibroblast growth factor 23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease. JAMA. 2011;305(23):2432-9. doi: 10.1001/jama.2011.826. [PubMed: 21673295]. [PubMed Central: PMC3124770].
  • 7. Faul C, Amaral AP, Oskouei B, Hu MC, Sloan A, Isakova T, et al. FGF23 induces left ventricular hypertrophy. J Clin Invest. 2011;121(11):4393-408. doi: 10.1172/JCI46122. [PubMed: 21985788]. [PubMed Central: PMC3204831].
  • 8. Seiler S, Reichart B, Roth D, Seibert E, Fliser D, Heine GH. FGF-23 and future cardiovascular events in patients with chronic kidney disease before initiation of dialysis treatment. Nephrol Dial Transplant. 2010;25(12):3983-9. doi: 10.1093/ndt/gfq309. [PubMed: 20525642].
  • 9. Lanske B, Razzaque MS. Molecular interactions of FGF23 and PTH in phosphate regulation. Kidney Int. 2014;86(6):1072-4. doi: 10.1038/ki.2014.316. [PubMed: 25427080]. [PubMed Central: PMC4246422].
  • 10. Lawson DE, Fraser DR, Kodicek E, Morris HR, Williams DH. Identification of 1,25-dihydroxycholecalciferol, a new kidney hormone controlling calcium metabolism. Nature. 1971;230(5291):228-30. [PubMed: 4323313].
  • 11. Holick MF, Schnoes HK, DeLuca HF, Gray RW, Boyle IT, Suda T. Isolation and identification of 24,25-dihydroxycholecalciferol, a metabolite of vitamin D made in the kidney. Biochemistry. 1972;11(23):4251-5. [PubMed: 4342902].
  • 12. Taal MW, Thurston V, McIntyre NJ, Fluck RJ, McIntyre CW. The impact of vitamin D status on the relative increase in fibroblast growth factor 23 and parathyroid hormone in chronic kidney disease. Kidney Int. 2014;86(2):407-13. doi: 10.1038/ki.2013.537. [PubMed: 24429404].
  • 13. Shardlow A, McIntyre NJ, Fluck RJ, McIntyre CW, Taal MW. Associations of fibroblast growth factor 23, vitamin D and parathyroid hormone with 5-year outcomes in a prospective primary care cohort of people with chronic kidney disease stage 3. BMJ Open. 2017;7(8). e016528. doi: 10.1136/bmjopen-2017-016528. [PubMed: 28838895]. [PubMed Central: PMC5629682].
  • 14. Stubbs J, Liu S, Quarles LD. Role of fibroblast growth factor 23 in phosphate homeostasis and pathogenesis of disordered mineral metabolism in chronic kidney disease. Semin Dial. 2007;20(4):302-8. doi: 10.1111/j.1525-139X.2007.00308.x. [PubMed: 17635819].
  • 15. Nitta K, Nagano N, Tsuchiya K. Fibroblast growth factor 23/klotho axis in chronic kidney disease. Nephron Clin Pract. 2014;128(1-2):1-10. doi: 10.1159/000365787. [PubMed: 25402964].
  • 16. Shimada T, Hasegawa H, Yamazaki Y, Muto T, Hino R, Takeuchi Y, et al. FGF-23 is a potent regulator of vitamin D metabolism and phosphate homeostasis. J Bone Miner Res. 2004;19(3):429-35. doi: 10.1359/JBMR.0301264. [PubMed: 15040831].
  • 17. Chao CT, Lee SY, Yen CJ, Chiang CK, Huang JW, Hung KY. Serum free 1,25-dihydroxy-vitamin D is more closely associated with fibroblast growth factor 23 than other vitamin D forms in chronic dialysis patients. Clin Chim Acta. 2015;439:122-7. doi: 10.1016/j.cca.2014.10.022. [PubMed: 25451947].
  • 18. Mizuiri S, Nishizawa Y, Yamashita K, Ono K, Oda M, Usui K, et al. Lower serum fibroblast growth factor-23 levels may suggest malnutrition in maintenance haemodialysis patients. Nephrology (Carlton). 2014;19(9):568-73. doi: 10.1111/nep.12290. [PubMed: 24947687].
  • 19. Hsu JJ, Katz R, Ix JH, de Boer IH, Kestenbaum B, Shlipak MG. Association of fibroblast growth factor-23 with arterial stiffness in the Multi-Ethnic Study of Atherosclerosis. Nephrol Dial Transplant. 2014;29(11):2099-105. doi: 10.1093/ndt/gfu101. [PubMed: 24782533]. [PubMed Central: PMC4209876].
  • 20. Weber TJ, Liu S, Indridason OS, Quarles LD. Serum FGF23 levels in normal and disordered phosphorus homeostasis. J Bone Miner Res. 2003;18(7):1227-34. doi: 10.1359/jbmr.2003.18.7.1227. [PubMed: 12854832].
  • 21. Shen J, Fu S, Song Y. Relationship of fibroblast growth factor 23 (FGF-23) serum levels with low bone mass in postmenopausal women. J Cell Biochem. 2017;118(12):4454-9. doi: 10.1002/jcb.26101. [PubMed: 28464278].
  • 22. Yoshiko Y, Wang H, Minamizaki T, Ijuin C, Yamamoto R, Suemune S, et al. Mineralized tissue cells are a principal source of FGF23. Bone. 2007;40(6):1565-73. doi: 10.1016/j.bone.2007.01.017. [PubMed: 17350357].
  • 23. Sridharan M, Cheung J, Moore AE, Frost ML, Fraser WD, Fogelman I, et al. Circulating fibroblast growth factor-23 increases following intermittent parathyroid hormone (1-34) in postmenopausal osteoporosis: Association with biomarker of bone formation. Calcif Tissue Int. 2010;87(5):398-405. doi: 10.1007/s00223-010-9414-8. [PubMed: 20838781].
  • 24. Samadfam R, Richard C, Nguyen-Yamamoto L, Bolivar I, Goltzman D. Bone formation regulates circulating concentrations of fibroblast growth factor 23. Endocrinology. 2009;150(11):4835-45. doi: 10.1210/en.2009-0472. [PubMed: 19819968].
  • 25. Razzaque MS. The FGF23-Klotho axis: Endocrine regulation of phosphate homeostasis. Nat Rev Endocrinol. 2009;5(11):611-9. doi: 10.1038/nrendo.2009.196. [PubMed: 19844248]. [PubMed Central: PMC3107967].
  • 26. Kendrick J, Cheung AK, Kaufman JS, Greene T, Roberts WL, Smits G, et al. FGF-23 associates with death, cardiovascular events, and initiation of chronic dialysis. J Am Soc Nephrol. 2011;22(10):1913-22. doi: 10.1681/ASN.2010121224. [PubMed: 21903574]. [PubMed Central: PMC3187186].
  • 27. Prie D, Urena Torres P, Friedlander G. Latest findings in phosphate homeostasis. Kidney Int. 2009;75(9):882-9. doi: 10.1038/ki.2008.643. [PubMed: 19190675].
  • 28. Schneider A, Schneider MP, Krieter DH, Genser B, Scharnagl H, Stojakovic T, et al. Effect of high-flux dialysis on circulating FGF-23 levels in end-stage renal disease patients: Results from a randomized trial. PLoS One. 2015;10(5). e0128079. doi: 10.1371/journal.pone.0128079. [PubMed: 26024521]. [PubMed Central: PMC4449206].
  • 29. Wetmore JB, Santos PW, Mahnken JD, Krebill R, Menard R, Gutta H, et al. Elevated FGF23 levels are associated with impaired calcium-mediated suppression of PTH in ESRD. J Clin Endocrinol Metab. 2011;96(1):E57-64. doi: 10.1210/jc.2010-1277. [PubMed: 20943782]. [PubMed Central: PMC3038477].
  • 30. Jean G, Terrat JC, Vanel T, Hurot JM, Lorriaux C, Mayor B, et al. High levels of serum fibroblast growth factor (FGF)-23 are associated with increased mortality in long haemodialysis patients. Nephrol Dial Transplant. 2009;24(9):2792-6. doi: 10.1093/ndt/gfp191. [PubMed: 19395730].
  • 31. Negishi K, Kobayashi M, Ochiai I, Yamazaki Y, Hasegawa H, Yamashita T, et al. Association between fibroblast growth factor 23 and left ventricular hypertrophy in maintenance hemodialysis patients. Comparison with B-type natriuretic peptide and cardiac troponin T. Circ J. 2010;74(12):2734-40. [PubMed: 21041973].

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