Mark R Hanudel1, Marciana Laster2, Isidro B Salusky2. 1. UCLA Department of Pediatrics, Division of Pediatric Nephrology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, MDCC A2-383, Los Angeles, CA, 90095-1752, USA. mhanudel@mednet.ucla.edu. 2. UCLA Department of Pediatrics, Division of Pediatric Nephrology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, MDCC A2-383, Los Angeles, CA, 90095-1752, USA.
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.
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.
Entities:
Keywords:
Anemia; CKD-mineral and bone disorder; Chronic kidney disease; Fibroblast growth factor 23; Iron
Authors: Erik A Imel; Munro Peacock; Amie K Gray; Leah R Padgett; Siu L Hui; Michael J Econs Journal: J Clin Endocrinol Metab Date: 2011-08-31 Impact factor: 5.958
Authors: Rupal Mehta; Xuan Cai; Alexander Hodakowski; Jungwha Lee; Mary Leonard; Ana Ricardo; Jing Chen; Lee Hamm; James Sondheimer; Mirela Dobre; Valentin David; Wei Yang; Alan Go; John W Kusek; Harold Feldman; Myles Wolf; Tamara Isakova Journal: Clin J Am Soc Nephrol Date: 2017-08-07 Impact factor: 8.237
Authors: Jair Munoz Mendoza; Tamara Isakova; Ana C Ricardo; Huiliang Xie; Sankar D Navaneethan; Amanda H Anderson; Lydia A Bazzano; Dawei Xie; Matthias Kretzler; Lisa Nessel; L Lee Hamm; Lavinia Negrea; Mary B Leonard; Dominic Raj; Myles Wolf Journal: Clin J Am Soc Nephrol Date: 2012-05-03 Impact factor: 8.237
Authors: Qian Zhang; Michele Doucet; Ryan E Tomlinson; Xiaobin Han; L Darryl Quarles; Michael T Collins; Thomas L Clemens Journal: Bone Res Date: 2016-07-05 Impact factor: 13.567
Authors: Mark R Hanudel; Marciana L Laster; Anthony A Portale; Aditi Dokras; Raymond P Quigley; German A Lozano Guzman; Joshua J Zaritsky; Nicole A Hayde; Frederick J Kaskel; Mark M Mitsnefes; Jorge A Ramirez; Peace D Imani; Poyyapakkam R Srivaths; Amy J Kogon; Michelle R Denburg; Tom D Blydt-Hansen; Loretta Z Reyes; Larry A Greenbaum; Darcy K Weidemann; Bradley A Warady; David A Elashoff; Susan R Mendley; Tamara Isakova; Isidro B Salusky Journal: Pediatr Nephrol Date: 2022-03-02 Impact factor: 3.651