Fibroblast growth factor (FGF) 23 and FGF receptor 4 induced cardiac mitochondrial dysfunction as a new target in

Dieter Haffner1, Maren Leifheit-Nestler1

  • 1Department of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Hannover Medical School, Hannover, Germany.

Kidney International
|April 20, 2025
PubMed

Insights

Fibroblast growth factor 23 (FGF23) promotes cardiovascular mortality in chronic kidney disease. FGF23-FGF receptor 4 signaling causes early cardiac mitochondrial dysfunction and metabolic remodeling before structural changes occur.

Area of Science:

  • Nephrology
  • Cardiology
  • Molecular Biology

Background:

  • Chronic kidney disease (CKD) is linked to high cardiovascular mortality.
  • The phosphaturic hormone fibroblast growth factor 23 (FGF23) is implicated in CKD's cardiovascular complications.
  • Elevated FGF23 contributes to left ventricular hypertrophy through FGF receptor 4 (FGFR4) activation.

Purpose of the Study:

  • To investigate the role of FGF23-FGFR4 signaling in early cardiac complications of CKD.
  • To explore FGF23's impact on cardiac mitochondrial function and metabolism.

Main Methods:

  • Utilized bioengineered cardiobundles.
  • Employed neonatal rat ventricular myocytes.
  • Studied mice models with induced chronic kidney disease.

Main Results:

  • Demonstrated FGF23-FGFR4 activation as a mechanism for cardiac mitochondrial dysfunction in CKD.
  • Showed FGF23-FGFR4 signaling contributes to metabolic remodeling in the heart.
  • Identified these cardiac changes occur before structural alterations in CKD.

Conclusions:

  • FGF23-FGFR4 signaling is a key driver of early cardiac mitochondrial dysfunction and metabolic remodeling in CKD.
  • These molecular and metabolic changes precede the development of structural cardiac abnormalities in CKD.
  • Targeting FGF23-FGFR4 pathways may offer therapeutic strategies for CKD-associated cardiovascular disease.