Abstract
BackgroundExpression and/or excretion of fibroblast growth factor-23 (FGF23) and its co-receptor Klotho are altered in patients with end-stage renal disease. The possibility that the FGF23/α-Klotho system mediates the aggravated cardiovascular outcome among patients with chronic kidney disease (CKD) has been suggested. We determined whether FGF23 and α-Klotho concentrations are altered among patients with reduced renal function and proteinuria.MethodsSerum FGF23 and α-Klotho were measured in cardiology patients who were not undergoing chronic hemodialysis. Estimated glomerular filtration rate (eGFR) was correlated negatively with FGF23 and positively with α-Klotho.ResultsThe correlation between FGF23 and the renal tubular maximum reabsorption rate of phosphate to the GFR (TmP/GFR) was not significant, but that between FGF23 and serum calcium or inorganic phosphate was significant among patients with an estimated GFR of less than 60 mL/min/m2. By stepwise multivariate regression analysis, eGFR was selected as significant predictor for FGF23 or α-Klotho among patients with an estimated GFR of less than 60 mL/min/m2; however, urine albumin/creatinine ratio was not selected as a predictor for FGF23 or α-Klotho irrespective of the eGFR levels. In patients with eGFR of <60 mL/min/1.73 m2, UACR was significantly associated with log(FGF23); but, this association did not remain statistically significant in a multivariate model.ConclusionsAmong cardiology patients with various stages of CKD, serum concentrations of FGF23 and α-Klotho were associated with renal function, but not with the extent of proteinuria.
Highlights
Expression and/or excretion of fibroblast growth factor-23 (FGF23) and its co-receptor Klotho are altered in patients with end-stage renal disease
Together with the observation that reduced α-Klotho is associated with coronary artery disease [10], these findings suggested that modulation of FGF23/αKlotho may represent one of the crucial factors underlying the cardiac [11] and vascular remodeling observed in patients with chronic kidney disease (CKD)
In the current study, we investigated the association of the extent of proteinuria, as well as Estimated glomerular filtration rate (eGFR), with circulating levels of α-Klotho and FGF23 among cardiology patients
Summary
Expression and/or excretion of fibroblast growth factor-23 (FGF23) and its co-receptor Klotho are altered in patients with end-stage renal disease. Among patients with endstage renal disease, serum levels of FGF23 increase in response to elevated serum phosphorus, and those of α-Klotho decrease. Among patients with end-stage renal disease, serum levels of FGF23 increase in response. Relationship between FGF23/α-Klotho and proteinuria seems to have been less extensively examined far, as compared with that between GFR and FGF23/α-Klotho [20]. To this end, in the current study, we investigated the association of the extent of proteinuria, as well as eGFR, with circulating levels of α-Klotho and FGF23 among cardiology patients
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