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Klotho/FGF23 Axis in CKD

Ken Tsuchiya1, Nobuo Nagano, Kosaku Nitta

  • 1Department of Medicine IV, Tokyo Women's Medical University, Tokyo, Japan.

Contributions to Nephrology
|May 30, 2015
PubMed

Insights

Chronic kidney disease (CKD) mineral and bone disorder (MBD) involves Klotho and fibroblast growth factor 23 (FGF23). Understanding their roles in CKD-MBD is crucial for clinical practice and patient outcomes.

Area of Science:

  • Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Chronic kidney disease (CKD) is linked to mineral and bone disorder (CKD-MBD), characterized by bone abnormalities, altered serum parameters, and vascular calcification.
  • Klotho, an aging-related protein, and fibroblast growth factor 23 (FGF23), a bone-derived factor, are implicated in CKD-MBD pathophysiology.
  • The interplay between Klotho and FGF23 in kidney function and mineral homeostasis is increasingly recognized.

Purpose of the Study:

  • To elucidate the pathophysiology of Klotho and FGF23 in the context of CKD-MBD.
  • To highlight the emerging roles of Klotho and FGF23 as potential surrogate markers in CKD.
  • To discuss the clinical implications of understanding these factors in CKD management.

Main Methods:

  • Review of existing literature on Klotho, FGF23, and CKD-MBD.
  • Analysis of the functional relationship between Klotho and FGF23 in renal phosphate and vitamin D regulation.
  • Examination of clinical data regarding blood Klotho and FGF23 levels in CKD patients.

Main Results:

  • Klotho acts as a cofactor for FGF23, mediating its effects on phosphate and vitamin D metabolism in the kidney.
  • Elevated blood levels of Klotho and FGF23 are observed early in CKD progression.
  • These elevated levels are associated with patient life expectancy, suggesting their utility as surrogate markers.

Conclusions:

  • Klotho and FGF23 play significant roles in the pathogenesis of CKD-MBD.
  • Their levels serve as important indicators in early CKD stages and may predict patient outcomes.
  • Further research into Klotho and FGF23 is essential for advancing clinical practice in managing CKD-MBD.

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