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Pediatric Nephrology
Published in: Pediatric Nephrology 5/2017

01-05-2017 | Educational Review

Extrarenal effects of FGF23

Authors: Dieter Haffner, Maren Leifheit-Nestler

Published in: Pediatric Nephrology | Issue 5/2017

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Abstract

Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular mortality, infections, and impaired cognitive function. It is characterized by excessively increased levels of the phosphaturic hormone fibroblast growth factor 23 (FGF23) and a deficiency of its co-receptor Klotho. Despite the important physiological effect of FGF23 in maintaining phosphate homeostasis, there is increasing evidence that higher FGF23 levels are a risk factor for mortality and cardiovascular disease. FGF23 directly induces left ventricular hypertrophy via activation of the FGF receptor 4/calcineurin/nuclear factor of activated T cells signaling pathway. By contrast, the impact of FGF23 on endothelial function and the development of atherosclerosis are poorly understood. The results of recent experimental studies indicate that FGF23 directly impacts on hippocampal neurons and may thereby impair learning and memory function in CKD patients. Finally, it has been shown that FGF23 interferes with the immune system by directly acting on polymorphonuclear leukocytes and macrophages. In this review, we discuss recent data from clinical and experimental studies on the extrarenal effects of FGF23 with respect to the cardiovascular, central nervous, and immune systems.
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Metadata
Title
Extrarenal effects of FGF23
Authors
Dieter Haffner
Maren Leifheit-Nestler
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 5/2017
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-016-3505-3

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