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Urinary Fibroblast Growth Factor-23 and Soluble Alpha-Klotho in Cats with Chronic Kidney Disease

Wei-Che Chen1, Wei-Li Hsu2, Chao-Chin Chang2

  • 1Institute of Veterinary Clinical Science, School of Veterinary Medicine, College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan; National Taiwan University Veterinary Hospital, College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan.

Veterinary Journal (London, England : 1997)
|March 23, 2026
PubMed

Insights

Urinary Fibroblast growth factor 23 (FGF23) and α-Klotho (KL) levels increase with feline chronic kidney disease (CKD) progression. Lower urinary KL is a key predictor of CKD advancement in cats.

Area of Science:

  • Veterinary Medicine
  • Nephrology
  • Biochemistry

Background:

  • Fibroblast growth factor 23 (FGF23) and α-Klotho (KL) are critical regulators of mineral and bone metabolism.
  • Their roles in feline chronic kidney disease-mineral and bone disorder (CKD-MBD) are not well understood due to limited urinary studies.
  • Understanding these biomarkers is essential for managing feline CKD progression.

Purpose of the Study:

  • To evaluate urinary FGF23 (uFGF23) and soluble α-Klotho (uKL) concentrations in cats with varying stages of CKD.
  • To assess the relationship between uFGF23, uKL, and CKD progression, including acute decompensated chronic kidney disease (ACKD).
  • To identify potential urinary biomarkers for feline CKD assessment and prognosis.

Main Methods:

  • Quantification of uFGF23 and uKL using commercial ELISA kits.
  • Analysis of samples from 13 healthy cats, 71 CKD cats, and 28 ACKD cats.
  • Statistical analysis to compare biomarker levels across groups and assess prognostic value.

Main Results:

  • The urinary FGF23-to-creatinine ratio was significantly elevated in late-stage CKD and ACKD cats compared to healthy and early CKD cats.
  • A progressive decline in the urinary Klotho/FGF23 ratio was observed from healthy to late-stage CKD cats.
  • Lower levels of urinary Klotho were identified as an independent predictor of CKD progression in cats.

Conclusions:

  • Urinary FGF23 and Klotho levels, along with their ratio, show significant alterations with feline CKD progression.
  • These urinary biomarkers may serve as valuable tools for assessing the severity of CKD in cats.
  • Urinary Klotho levels show prognostic potential for predicting CKD progression in feline patients.

Keywords:
ACKDBiomarkerCKD-MBDFelineHyperphosphatemiaProgression

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