Katherine Wesseling-Perry1, Hejing Wang, Robert Elashoff, Barbara Gales, Harald Jüppner, Isidro B Salusky. 1. Department of Pediatrics (K.W.-P., H.W., R.E., B.G., I.B.S.), David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California 90095; and Endocrine Unit and Division of Pediatric Nephrology (H.J.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114.
Abstract
CONTEXT: 1,25-Dihydroxyvitamin D (1,25D) administration and long-term increases in phosphate, PTH, and calcium concentrations are associated with increases in circulating fibroblast growth factor 23 (FGF23); however, whether or not acute changes in serum calcium modulate short-term FGF23 release is unknown. OBJECTIVE/ DESIGN: To assess the direct effect of acute changes in calcium and PTH on circulating FGF23 levels. SETTING: A university clinical and translational research center. PATIENTS/PARTICIPANTS: Twelve healthy volunteers and 10 dialysis patients. INTERVENTIONS: Calcium gluconate and sodium citrate were infused for 120 minutes on 2 consecutive days. MAIN OUTCOME MEASURES: Serum levels of ionized calcium, phosphorus, PTH, 1,25D, and plasma C-terminal FGF23 levels were obtained at 0, 13, 30, 60, 90, and 120 minutes during the infusions. RESULTS: During the calcium infusion, serum calcium concentrations increased from 1.33 ± 0.01 to 1.57 ± 0.04 mmol/L (P < .05 from baseline) and from 1.20 ± 0.05 to 1.50 ± 0.03 mmol/L (P < .05 from baseline) in healthy subjects and in dialysis patients, respectively, whereas serum calcium values decreased from 1.33 ± 0.01 to 1.03 ± 0.02 mmol/L (P < .05 from baseline) and from 1.26 ± 0.04 to 1.07 ± 0.03 mmol/L (P < .05 from baseline) in the two groups, respectively during the sodium citrate infusion. PTH levels decreased from 35 (29, 57) to 8 (2,10) pg/mL (healthy subjects) (P < .05 from baseline) and from 292 (109, 423) to 44 (28, 86) pg/mL (dialysis patients) (P < .05 from baseline) during the calcium infusion and rose from 31 (25, 56) to 122 (95, 157) pg/mL and from 281 (117, 607) to 468 (169, 928) pg/mL (P < .05 from baseline) during sodium citrate infusion. Serum 1,25D levels and plasma FGF23 values remained unchanged during both infusions in both groups. CONCLUSIONS: Short-term changes in calcium and PTH levels do not affect FGF23 concentrations in either healthy volunteers or dialysis patients.
CONTEXT: 1,25-Dihydroxyvitamin D (1,25D) administration and long-term increases in phosphate, PTH, and calcium concentrations are associated with increases in circulating fibroblast growth factor 23 (FGF23); however, whether or not acute changes in serum calcium modulate short-term FGF23 release is unknown. OBJECTIVE/ DESIGN: To assess the direct effect of acute changes in calcium and PTH on circulating FGF23 levels. SETTING: A university clinical and translational research center. PATIENTS/PARTICIPANTS: Twelve healthy volunteers and 10 dialysis patients. INTERVENTIONS:Calcium gluconate and sodium citrate were infused for 120 minutes on 2 consecutive days. MAIN OUTCOME MEASURES: Serum levels of ionizedcalcium, phosphorus, PTH, 1,25D, and plasma C-terminal FGF23 levels were obtained at 0, 13, 30, 60, 90, and 120 minutes during the infusions. RESULTS: During the calcium infusion, serum calcium concentrations increased from 1.33 ± 0.01 to 1.57 ± 0.04 mmol/L (P < .05 from baseline) and from 1.20 ± 0.05 to 1.50 ± 0.03 mmol/L (P < .05 from baseline) in healthy subjects and in dialysis patients, respectively, whereas serum calcium values decreased from 1.33 ± 0.01 to 1.03 ± 0.02 mmol/L (P < .05 from baseline) and from 1.26 ± 0.04 to 1.07 ± 0.03 mmol/L (P < .05 from baseline) in the two groups, respectively during the sodium citrate infusion. PTH levels decreased from 35 (29, 57) to 8 (2,10) pg/mL (healthy subjects) (P < .05 from baseline) and from 292 (109, 423) to 44 (28, 86) pg/mL (dialysis patients) (P < .05 from baseline) during the calcium infusion and rose from 31 (25, 56) to 122 (95, 157) pg/mL and from 281 (117, 607) to 468 (169, 928) pg/mL (P < .05 from baseline) during sodium citrate infusion. Serum 1,25D levels and plasma FGF23 values remained unchanged during both infusions in both groups. CONCLUSIONS: Short-term changes in calcium and PTH levels do not affect FGF23 concentrations in either healthy volunteers or dialysis patients.
Authors: Ana L E Cancela; Rodrigo B Oliveira; Fabiana G Graciolli; Luciene M dos Reis; Fellype Barreto; Daniela V Barreto; Lilian Cuppari; Vanda Jorgetti; Aluizio B Carvalho; Maria Eugênia Canziani; Rosa M A Moysés Journal: Nephron Clin Pract Date: 2010-08-04
Authors: James B Wetmore; Peter W Santos; Jonathan D Mahnken; Ron Krebill; Rochelle Menard; Hema Gutta; L Darryl Quarles Journal: J Clin Endocrinol Metab Date: 2010-10-13 Impact factor: 5.958
Authors: O Kifor; F D Moore; P Wang; M Goldstein; P Vassilev; I Kifor; S C Hebert; E M Brown Journal: J Clin Endocrinol Metab Date: 1996-04 Impact factor: 5.958
Authors: María E Rodriguez-Ortiz; Ignacio Lopez; Juan R Muñoz-Castañeda; Julio M Martinez-Moreno; Alan Peralta Ramírez; Carmen Pineda; Antonio Canalejo; Philippe Jaeger; Escolastico Aguilera-Tejero; Mariano Rodriguez; Arnold Felsenfeld; Yolanda Almaden Journal: J Am Soc Nephrol Date: 2012-05-10 Impact factor: 10.121
Authors: Dominique Kosk; Holly Kramer; Amy Luke; Pauline Camacho; Pascal Bovet; Jacob Plange Rhule; Terrence Forrester; Myles Wolf; Chris Sempos; Michal L Melamed; Lara R Dugas; Richard Cooper; Ramon Durazo-Arvizu Journal: J Bone Miner Metab Date: 2016-12-09 Impact factor: 2.626