The role of fibroblast growth factor 23 in the assessment of complications in chronic kidney disease
- Urology & Nephrology Open Access Journal
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Dilyana Nikolova, Veselina Koleva
Abstract
Secondary hyperparathyroidism is an early-stage complication of CKD (Chronic Kidney
Disease). It is associated with disorders in bone metabolism, calcium deposition in vessels
and organs, significantly increased risk of cardiovascular disease, and death. In recent
years, an increasingly important role has been attributed to fibroblast growth factor (FGF
23) in regulating calcium/phosphate homeostasis, hyperparathyroidism, and its relation to
vascular calcification, and left ventricular hypertrophy.
This study conducted with 110 patients with varying degrees of renal insufficiency shows
an increase in FGF23 and PTH when there is a decrease in glomerular filtration, a direct
dependency between the levels of phosphate and PTH and FGF23, and a lack of such
between calcium and PTH and FGF23.
Of particular interest is the fact that patients treated with Calcitriol and Paricalcitol show a
reduction in PTH levels, yet maintain high levels of FGF23. PTH serves as a marker for the
rate of bone remodeling in patients, where elevated levels indicate renal bone disease. The
analysis of FGF 23 is crucial in evaluating cardiovascular risk.
Keywords
secondary hyperparathyroidism, calcium, phosphorus, alkaline phosphatase, fibroblast growth factor 23
