Abstract

Fibroblast growth factor 23 (FGF23) is a recently discovered hormone that is a key regulator of systemic phosphate metabolism. It is expressed in bone and has endocrine effects on renal and parathyroid gland function. FGF23 and its co-factor Klotho interact with vitamin D and parathyroid hormone to form a delicate regulatory network that maintains the optimal balance of mineral ions in the body that is critical for health and survival. This chapter explains the biology and physiology of FGF23, how it interacts with the other calcium and phosphate regulating hormones to maintain mineral ion homeostasis, and how its dysregulation contributes to renal and skeletal disorders.

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