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International Journal of Nephrology
Volume 2011, Article ID 297070, 6 pages
http://dx.doi.org/10.4061/2011/297070
Clinical Study

Fibroblast Growth Factor 23 Predicts Left Ventricular Mass and Induces Cell Adhesion Molecule Formation

1Renal Research Group, ICAMS, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
2Renal Unit, Western Infirmary, Glasgow G11 6NT, UK

Received 7 May 2011; Accepted 22 May 2011

Academic Editor: Biagio Raffaele Di Iorio

Copyright © 2011 Kathryn K. Stevens et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Elevated FGF-23 is a predictor of mortality and is associated with LVH in CKD. It may be a biomarker or a direct toxin. We assessed the relationship between FGF-23 and LVH in CKD using CMRI. In vitro we studied the effect of phosphate, FGF-23, and Klotho on E-selectin and VCAM production in HUVECs. FGF-23 concentration correlates negatively with eGFR and positively with LVMI. FGF-23 was an independent predictor of LVH in CKD. E-selectin and VCAM production was elevated in HUVECs cultured in high phosphate with FGF-23 or Klotho. This effect was attenuated in cells exposed to both FGF-23 and Klotho. FGF-23 is an independent predictor of LVH as measured by CMRI. We show preliminary data which supports that FGF-23 is toxic resulting in activation of the vascular endothelium. We do not prove causality with elevated FGF-23 and LVH. Further research should ascertain if lowering levels of FGF-23 translates to improved clinical outcomes.