FGF-23 and sFRP-4 in Chronic Kidney Disease and Post-Renal Transplantation
| Autor: | John Vassiliadis, Susan C. Schiavi, Eduardo Slatapolsky, Karen Wiesen, Cynthia S. Ritter, Rajesh Kumar, Marcos Rothstein, Sangeeta Pande, Alex J. Brown |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
Fibroblast growth factor 23 Nephrology medicine.medical_specialty Hypophosphatemia Physiology Article Phosphates Hyperphosphatemia Postoperative Complications Proto-Oncogene Proteins Physiology (medical) Internal medicine medicine Humans Kidney transplantation Reabsorption business.industry General Medicine medicine.disease Kidney Transplantation Fibroblast Growth Factors Transplantation Fibroblast Growth Factor-23 Kidney Tubules Endocrinology Parathyroid Hormone Kidney Failure Chronic Female business Kidney disease |
| Zdroj: | Nephron Physiology. 104:p23-p32 |
| ISSN: | 1660-2137 |
| DOI: | 10.1159/000093277 |
| Popis: | Background: The phosphatonins fibroblast growth factor-23 (FGF-23) and FRP-4 are inhibitors of tubular phosphate reabsorption that may play a role in the hyperphosphatemia associated with chronic kidney disease (CKD) or in the hypophosphatemia associated with renal transplants. Methods: Plasma FGF-23, FRP-4, phosphorus and parathyroid hormone were measured in patients at all stages of CKD. Phosphate regulation of FGF-23 and secreted frizzled related protein-4 (sFRP-4) was examined in end-stage renal disease patients in the presence and absence of therapeutic phosphate binder usage. In renal transplant patients, plasma FGF-23, sFRP-4 and phosphorus concentrations were determined before and 4–5 days after transplantation. Results: Plasma FGF-23 correlated with creatinine clearance (r2 = –0.584, p < 0.0001) and plasma phosphorus (r2 = 0.347, p < 0.001) in CKD patients and with plasma phosphorus (r2 = 0.448, p < 0.001) in end-stage renal disease patients. Phosphate binder withdrawal increased FGF-23 levels. In kidney transplant patients, dramatic decreases in FGF-23 (–88.8 ± 5.4%) and phosphorus (–64 ± 10.2%) were observed by 4–5 days post-transplantation. In patients with post-transplant hypophosphatemia, FGF-23 levels correlated inversely with plasma phosphorus (r2 = 0.661, p < 0.05). sFRP-4 levels did not change with creatinine clearance or hyperphosphatemia in CKD or end-stage renal disease patients, and no relation was noted between post-transplant sFRP-4 levels and hypophosphatemia. Conclusions: In CKD, FGF-23 levels rose with decreasing creatinine clearance rates and increasing plasma phosphorus levels, and rapidly decreased post-transplantation suggesting FGF-23 is cleared by the kidney. Residual FGF-23 may contribute to the hypophosphatemia in post-transplant patients. |
| Databáze: | OpenAIRE |
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