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Fibroblast growth factor 23 and bone metabolism in children with chronic kidney disease

Michael van Husen1, Ann-Katrin Fischer, Anja Lehnhardt

  • 1Department of Pediatric Nephrology, University Medical Center, Martinistrasse, Hamburg, Germany. mhusen@uke.de

Kidney International
|April 22, 2010
PubMed

Insights

Fibroblast growth factor 23 (FGF23) is elevated in pediatric chronic kidney disease (CKD), impacting phosphate and vitamin D levels early. This finding highlights FGF23

Area of Science:

  • Pediatric Nephrology
  • Mineral and Bone Metabolism
  • Endocrinology

Background:

  • Fibroblast growth factor 23 (FGF23) is a key regulator of phosphate and vitamin D metabolism.
  • Elevated FGF23 is linked to cardiovascular morbidity in adult chronic kidney disease (CKD).
  • The role of FGF23 in pediatric CKD requires further elucidation.

Purpose of the Study:

  • To investigate the role of FGF23 in pediatric patients with varying stages of CKD.
  • To examine the relationship between FGF23 and other bone metabolism markers in pediatric CKD.

Main Methods:

  • Study included 69 pediatric patients across different stages of CKD.
  • Measured FGF23 levels and other biochemical variables related to bone metabolism.
  • Utilized multivariate analysis to identify significant factors.

Main Results:

  • FGF23 levels were significantly elevated in CKD stages 3 and 5 compared to stages 1 and 2.
  • Elevated FGF23 preceded hyperphosphatemia in stage 4 CKD.
  • FGF23 positively correlated with parathyroid hormone and phosphate, and negatively with 1,25-dihydroxyvitamin D, eGFR, and tubular phosphate reabsorption.

Conclusions:

  • FGF23 plays a significant role in pediatric calcium, phosphate, and vitamin D homeostasis, even in early CKD.
  • Hyperphosphatemia and low estimated glomerular filtration rate (eGFR) were key factors in multivariate analysis.
  • Further research is needed on FGF23's role in pediatric renal osteodystrophy and cardiovascular outcomes.

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