Simultaneous management of disordered phosphate and iron homeostasis to correct fibroblast growth factor 23 and associated outcomes in chronic kidney disease.
Journal
Current opinion in nephrology and hypertension
ISSN: 1473-6543
Titre abrégé: Curr Opin Nephrol Hypertens
Pays: England
ID NLM: 9303753
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
pubmed:
27
5
2020
medline:
5
2
2021
entrez:
27
5
2020
Statut:
ppublish
Résumé
Hyperphosphatemia, iron deficiency, and anemia are powerful stimuli of fibroblast growth factor 23 (FGF23) production and are highly prevalent complications of chronic kidney disease (CKD). In this manuscript, we put in perspective the newest insights on FGF23 regulation by iron and phosphate and their effects on CKD progression and associated outcomes. We especially focus on new studies aiming to reduce FGF23 levels, and we present new data that suggest major benefits of combined corrections of iron, phosphate, and FGF23 in CKD. New studies show that simultaneously correcting iron deficiency and hyperphosphatemia in CKD reduces the magnitude of FGF23 increase. Promising therapies using iron-based phosphate binders in CKD might mitigate cardiac and renal injury and improve survival. New strategies to lower FGF23 have emerged, and we discuss their benefits and risks in the context of CKD. Novel clinical and preclinical studies highlight the effects of phosphate restriction and iron repletion on FGF23 regulation.
Identifiants
pubmed: 32452919
doi: 10.1097/MNH.0000000000000614
pmc: PMC7769207
mid: NIHMS1651308
pii: 00041552-202007000-00003
doi:
Substances chimiques
FGF23 protein, human
0
Phosphates
0
Fibroblast Growth Factors
62031-54-3
Fibroblast Growth Factor-23
7Q7P4S7RRE
Iron
E1UOL152H7
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
359-366Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK102815
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK114158
Pays : United States
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