Fibroblast growth factor 23 and soluble Klotho in patients with autosomal dominant polycystic kidney disease

This study aimed to examine the roles of fibroblast growth factor 23 (FGF23) and soluble Klotho in phosphate metabolism in autosomal-dominant polycystic kidney disease (ADPKD) patients.

We measured these two factors and phosphate metabolism parameters in 80 patients with ADPKD and 53 patients with non-diabetic chronic kidney disease (CKD).

The mean serum FGF23 level in the ADPKD group was significantly (twofold) higher than in the non-diabetic CKD patients, but the mean soluble Klotho level in the ADPKD group was significantly lower in the non-diabetic CKD group. The mean serum phosphate levels of the two groups were similar. The estimated glomerular filtration rate (eGFR) was approximately 45 mL/min per 1.73 m² in both groups, and their serum vitamin D metabolite levels were in the normal range.

The serum FGF23 levels were significantly higher and soluble Klotho levels significantly lower in the ADPKD group than in the non-diabetic CKD group matched for eGFR, and these findings may be associated with resistance of renal phosphate excretion.