Title:New Insights into the Role of FGF-23 and Klotho in Cardiovascular Disease in Chronic Kidney Disease Patients
Volume: 19
Issue: 1
Author(s): Evangelos Memmos and Aikaterini Papagianni*
Affiliation:
- Department of Nephrology, Aristotle University of Thessaloniki, General Hospital “Hippokratio”, Thessaloniki,Greece
Keywords:
Cardiovascular disease, chronic kidney disease, fibroblast growth factor-23, Klotho, uremic vasculopathy.
Abstract: Alterations of fibroblast growth factor 23 (FGF-23) and Klotho levels are considered to be
the earliest biochemical abnormality of chronic kidney disease – mineral and bone disease (CKDMBD)
syndrome. Moreover, emerging data suggests that the dysregulated FGF-23 and Klotho
axis has many effects on the cardiovascular (CV) system and contributes significantly to the increased
CV morbidity and mortality rates of CKD patients. This review examines recent evidence on the role
of FGF-23 and Klotho in the development and progression of CV complications of uremia namely
cardiac hypertrophy, uremic cardiomyopathy, and atherosclerotic and arteriosclerotic vascular lesions.
Moreover, the available evidence on their associations with adverse clinical outcomes are summarized.
Undoubtedly, more studies are needed to further elucidate the effects of FGF-23 and Klotho on the
heart and vessels and to gain insights into their prognostic value as CV risk factors. Finally,
large prospective studies are required to test the hypothesis that modification of their levels would have
a favourable impact on the unacceptably high mortality rates of these patient populations.
