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FGF23 in renal failure 

FGF23 in renal failure
Chapter:
FGF23 in renal failure
Author(s):

Katherine Wesseling-Perry

and Myles Wolf

DOI:
10.1093/med/9780199559176.003.024
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date: 20 February 2020

FGF23 plays a central role in phosphorus metabolism. This role was initially delineated by the study of genetic and acquired conditions of hypophosphatemic rickets but the greatest clinical impact of the discovery of FGF23 may be in the management of CKD patients. In patients with CKD, FGF23 levels rise as renal function declines, likely due to decreasing capacity of the damaged kidney to excrete dietary phosphorus loads. Rising FGF23 levels appear to contribute to the initiation of secondary hyperparathyroidism in CKD patients; however, increased levels of FGF23 also appear to contribute to or serve as markers of accelerated progression to renal failure, increased rates of mortality, and alterations in skeletal mineralization. Collectively, these results suggest that the effects of FGF23 on end-organ function in the context of chronic kidney disease differ markedly from the physiology observed in individuals with normal renal function.

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