THE SIGNIFICANCE OF FIBROBLAST GROWTH FACTOR 23 (FGF-23) IN HUMANS
DOI:
https://doi.org/10.31082/1728-452X-2020-217-218-7-8-37-43Keywords:
fibroblast growth factor-23, phosphate, parathyroid hormone, left ventricular hypertrophy, mineral-bone disorderAbstract
Nowadays chronic kidney disease (CKD) is one of the leading chronic non-communicable diseases in terms of morbidity and mortality. One of the most serious complications is mineral-bone disorder, which worsen the clinical course and prognosis of patients. Fibroblast growth factor 23 (FGF-23) is a new biomarker that regulates phosphate metabolism and plays an important role in the pathogenesis of many complications in CKD.
Purpose. To study the physiological role of FGF-23, as well as its potential clinical significance in the progression of CKD and its complications.
Material and methods. A 20-year-deep literature search was conducted in the international scientific databases PubMed / Medline, Web of Science and Google Scholar for the following keywords: "Fibroblast growth factor 23", "FGF-23", "phosphate homeostasis", "chronic kidney disease", "Mineral and bone disorders", "left ventricular hypertrophy".
Results and discussion. FGF-23 is a protein secreted by bone cells and its primary physiological role is to regulate urinary excretion of phosphate to maintain a stable level in serum. Moreover, FGF-23 decreases calcitriol levels and inhibits parathyroid hormone secretion. In CKD, there is a gradual increase in FGF-23 levels as renal function declines, which can be regarded as physiological compensation to stabilize serum phosphate levels. According to the several studies, FGF-23 might be associated with cardiovascular complications, such as left ventricular hypertrophy and heart failure.
Conclusion. Thus, FGF-23 is not only a marker of mineral-bone disorders in CKD, but also a key link in the pathogenesis of the development of secondary hyperparathyroidism and cardiovascular complications. With this in mind, FGF-23 may represent a multifunctional therapeutic target that may improve the prognosis of patients with CKD.
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