FGF-23 in patients with end-stage renal disease on hemodialysis

Imanishi, Yasuo; Inaba, Masaaki; Nakatsuka, Kiyoshi; Nagasue, Kyoko; Okuno, Senji; Yoshihara, Asami; Miura, Masaru; Miyauchi, Akimitsu; Kobayashi, Keisuke; Miki, Takami; Shoji, Tetsuo; Ishimura, Eiji; Nishizawà, Yoshiki

doi:10.1111/j.1523-1755.2004.00604.x

Cited by 251 publications

(187 citation statements)

References 10 publications

Supporting

Mentioning

168

Contrasting

Unclassified

Order By: Relevance

“…However, Ca has no effect on FGF-23 promoter activity in cultured osteoblasts (40). Furthermore, it has been reported that serum FGF-23 concentration is positively correlated with serum P levels (41). In the present study, 5/6 Nx mice had high serum P levels, which was associated with high serum FGF-23 despite hypocalcemia.…”

Section: Discussionsupporting

confidence: 52%

High calcium diet alleviates 5/6 nephrectomy-induced bone deteriorations of lumbar vertebrae in mice

et al. 2018

View full text Add to dashboard Cite

Abstract. Dietary calcium (Ca) supplementation has beneficial effects on bone health. However, it is not clear whether a high calcium diet (HCD) following 5/6 nephrectomy (5/6 Nx) is beneficial to bone health. The aim of the present study was to examine the effects of an HCD on bone metabolism using a chronic kidney disease (CKD) mouse model. Male C57BL/6J mice were divided into three groups: Sham group, 5/6 Nx group and 5/6 Nx + HCD group. Mice were sacrificed 12 weeks post-surgery. Calcium (Ca) and creatinine (Cr) were measured using standard colorimetric methods and picric acid methods, respectively. Bone metabolism-associated markers, FGF-23, PTH, ALP-b and TRAP-5b were measured using ELISA kits. Lumbar vertebrae histomorphological analysis was performed using hematoxylin and eosin staining. The expression of osteoprotegerin (OPG) and receptor activator of nuclear factor κB ligand (RANKL) mRNA was detected using reverse transcription-quantitative polymerase chain reaction. Impaired renal function and histopathological damage was indicated in 5/6 Nx mice. However, HCD had no significant effects on these changes in 5/6 Nx mice. Notably, mineral metabolism disorder and histopathological damage to lumbar vertebrae were markedly improved in HCD-treated 5/6 Nx mice. Compared with 5/6 Nx mice, HCD supplementation significantly elevated the ratio of OPG/RANKL and inhibited RANKL mRNA expression in lumbar vertebrae. To conclude, the present findings indicated that increased Ca intake is effective in increasing bone mineral content of the lumbar vertebrae in 5/6 Nx mice. These results may provide a basis for the clinical use of dietary Ca supplementation as a therapeutic approach to treat CKD-induced disturbance of mineral metabolism and bone loss.

show abstract

Section: Discussionsupporting

confidence: 52%

High calcium diet alleviates 5/6 nephrectomy-induced bone deteriorations of lumbar vertebrae in mice

et al. 2018

View full text Add to dashboard Cite

show abstract

“…FGF23 has been suggested to play a role in vascular calcification in patients on regular HD [7]. Several studies have indicated that serum levels of FGF23 are elevated in HD patients, and recently, elevated FGF23 concentrations are independently associated with an increased risk of mortality in patients on regular HD [8]. This work was carried out to evaluate the prevalence of carotid artery atherosclerosis in patients with ESRD on regular haemodialysis and its relation to FGF23 plasma level.…”

Section: Introductionmentioning

confidence: 99%

Plasma Fibroblast Growth Factor-23 Level and its Relation to Carotid Artery Atherosclerosis in Hemodialysis Patients

Ghonemy¹

2017

UNOAJ

View full text Add to dashboard Cite

Background: Abnormalities in bone metabolism are a prevalent condition in CKD patients. FGF23 has been suggested to play a role in vascular calcification in patients on regular hemodialysis (HD).Objective: This work was carried out to evaluate the prevalence of carotid artery atherosclerosis in patients with end stage renal disease (ESRD) on regular haemodialysis and the role of FGF-23 in this event.Subject and methods: A total number of 50 patients aged over 18 years and on regular haemodialysis for one or more years were included in this study. Intact FGF-23 and other laboratory parameters were measured by specific methods for all patients; Also Duplex scan of the carotid arteries was performed to assess carotid intima-media thickness (CIMT) by high-resolution real-time B mode ultrasonography.Results: Serum phosphorus, CIMT, LDL, There found to be significantly high with increasing FGF 23 levels (pis 0.005, 0.001, 0.02 and 0.001 respectively). While albumin level was significantly lower with increasing FGF-23 level (p is 0.013). Levels of phosphorus, Parathyroid hormone (PTH) and CRP got significantly higher with the increase in (CIMT) (p is 0.007, 0.001 and 0.004 respectively). FGF 23 levels were significantly correlated with each of CIMT, phosphorus and PTH levels. Correlation was significant between CIMT and age of patient, blood pressure, diabetes, smoking habits, more hemodialysis duration, CRP, higher phosphorus level, FGF23 level, low serum albumin, and higher PTH level. From multiple regression analysis, the most important risk factors correlated to carotid artery atherosclerosis are FGF23, higher phosphorus level, CRP and Diabetes in the order. Conclusion:FGF23 is a risk factor for the occurrence of vascular atherosclerosis in hemodialysis patients Monitoring of the FGF23 levels may be recommended to predict the possibility of vascular atherosclerosis in those types of patients.

show abstract

“…At any time, approximately half of patients on conventional hemodialysis (HD) have serum phosphate above the recommended level (1)(2)(3)(4), and nearly all receive additional therapies (beyond HD) to lower phosphate (5). Elevated phosphate contributes to secondary hyperparathyroidism (6,7), elevated FGF23 levels (8,9), and vascular calcification (10 -12), which in turn predispose to mortality in this population (13)(14)(15). Observational studies have consistently demonstrated a potent and dose-dependent association between higher serum phosphate levels and mortality (1,3,(16)(17)(18), cardiovascular mortality and morbidity (3,4), and increased rates of hospitalization (14).…”

Section: Introductionmentioning

confidence: 99%

Prescribed Dietary Phosphate Restriction and Survival among Hemodialysis Patients

Lynch¹,

Lynch²,

Curhan³

et al. 2011

Clinical Journal of the American Society of Nephrology

131

102

View full text Add to dashboard Cite

SummaryBackground and objectives Hyperphosphatemia is common among hemodialysis patients. Although prescribed dietary phosphate restriction is a recommended therapy, little is known about the long-term effects on survival.Design, setting, participants, & measurements We conducted a post hoc analysis of data from the Hemodialysis Study (n ϭ 1751). Prescribed dietary phosphate was recorded at baseline and annually thereafter. Marginal structural proportional hazard models were fit to estimate the adjusted association between dietary phosphate restriction and mortality in the setting of time-dependent confounding.Results At baseline, prescribed daily phosphate was restricted to levels Յ870, 871 to 999, 1000, 1001 to 2000 mg, and not restricted in 300, 314, 307, 297, and 533 participants, respectively. More restrictive prescribed dietary phosphate was associated with poorer indices of nutritional status on baseline analyses and a persistently greater need for nutritional supplementation but not longitudinal changes in caloric or protein intake. On marginal structural analysis, there was a stepwise trend toward greater survival with more liberal phosphate prescription, which reached statistical significance among subjects prescribed 1001 to 2000 mg/d and those with no specified phosphate restriction: hazard ratios (95% CIs) 0.73 (0.54 to 0.97) and 0.71 (0.55 to 0.92), respectively. Subgroup analysis suggested a more pronounced survival benefit of liberal dietary phosphate prescription among nonblacks, participants without hyperphosphatemia, and those not receiving activated vitamin D.Conclusions Prescribed dietary phosphate restriction is not associated with improved survival among prevalent hemodialysis patients, and increased level of restriction may be associated with greater mortality particularly in some subgroups.

show abstract

FGF-23 in patients with end-stage renal disease on hemodialysis

Abstract: Serum phosphate, calcium, and intact PTH could be regulators of FGF-23 levels in uremic patients on maintenance hemodialysis. Our results may provide new insights into the pathophysiologic effects of FGF-23 on calcium-phosphate homeostasis.

Cited by 251 publications

References 10 publications

High calcium diet alleviates 5/6 nephrectomy-induced bone deteriorations of lumbar vertebrae in mice

High calcium diet alleviates 5/6 nephrectomy-induced bone deteriorations of lumbar vertebrae in mice

Plasma Fibroblast Growth Factor-23 Level and its Relation to Carotid Artery Atherosclerosis in Hemodialysis Patients

Prescribed Dietary Phosphate Restriction and Survival among Hemodialysis Patients

Contact Info

Product

Resources

About