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Review
. 2018 Dec;16(6):724-729.
doi: 10.1007/s11914-018-0492-2.

Non-renal-Related Mechanisms of FGF23 Pathophysiology

Mark R Hanudel  1 , Marciana Laster  2 , Isidro B Salusky  2
Affiliations
Review

Non-renal-Related Mechanisms of FGF23 Pathophysiology

Mark R Hanudel et al. Curr Osteoporos Rep. 2018 Dec.

Abstract

Purpose of review: We will review non-renal-related mechanisms of fibroblast growth factor 23 (FGF23) pathophysiology.

Recent findings: FGF23 production and metabolism may be affected by many bone, mineral, and kidney factors. However, it has recently been demonstrated that other factors, such as iron status, erythropoietin, and inflammation, also affect FGF23 production and metabolism. As these non-mineral factors are especially relevant in the setting of chronic kidney disease (CKD), they may represent emerging determinants of CKD-associated elevated FGF23 levels. Moreover, FGF23 itself may promote anemia and inflammation, thus contributing to the multifactorial etiologies of these CKD-associated comorbidities. CKD-relevant, non-mineral-related, bidirectional relationships exist between FGF23 and anemia, and between FGF23 and inflammation. Iron deficiency, anemia, and inflammation affect FGF23 production and metabolism, and FGF23 itself may contribute to anemia and inflammation, highlighting complex interactions that may affect aspects of CKD pathogenesis and treatment.

Keywords: Anemia; CKD-mineral and bone disorder; Chronic kidney disease; Fibroblast growth factor 23; Iron.

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Conflict of interest statement

Conflict of Interest

Mark Hanudel, Marciana Laster, Isidro Salusky declare no conflict of interest.

Figures

<underline>Figure 1</underline>:
Figure 1:
Mineral and non-mineral factors involved in FGF23 regulation include phosphate, 1,25-dihydroxyvitamin D, parathyroid hormone, calcium, Klotho, iron, inflammation, and erythropoietin.
See this image and copyright information in PMC

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