Fibroblast Growth Factor 23, Iron and Inflammation - Are They Related in Early Stages of Chronic Kidney Disease?

Overview

Journal Arch Med Sci

Specialty General Medicine

Date 2017 Jul 20

PMID 28721153

Citations 9

Authors

Ewelina Lukaszyk

Mateusz Lukaszyk

Ewa Koc-Zorawska

Anna Bodzenta-Lukaszyk

Jolanta Malyszko

Affiliations

Soon will be listed here.

Abstract

Introduction: Fibroblast growth factor 23 (FGF-23) levels are elevated in impaired renal function. Inflammation and iron are potential regulators of FGF-23. The aim of the study was to evaluate the association between FGF-23 concentration, novel iron status biomarkers and inflammatory parameters among patients with early stages of chronic kidney disease (CKD).

Material And Methods: The study population included 84 patients with CKD in the early stage. Serum hemoglobin, fibrinogen, creatinine, iron, transferrin saturation and ferritin levels were measured using standard laboratory methods. Commercially available kits were used to measure: intact FGF-23, hepcidin, soluble transferrin receptor (sTfR), interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP).

Results: In patients with CKD no differences in FGF-23 concentration according to iron status were observed. Lower iron concentration was associated with higher concentrations of hsCRP, IL-6 and fibrinogen. In univariate and multivariate analysis FGF-23 correlated with fibrinogen ( = -0.23, < 0.05) and eGFR ( = -0.36, < 0.05).

Conclusions: FGF-23 is affected by kidney function and fibrinogen but not iron status parameters in the early stages of CKD. Our data are paving the way for further studies on the role of FGF-23 in iron metabolism, especially in early stages of CKD.

Citing Articles

Intact FGF23 and Markers of Iron Homeostasis, Inflammation, and Bone Mineral Metabolism in Acute Pediatric Infections.

Papastergiou E, Rallis D, Papagianni A, Cholevas V, Katzilakis N, Siomou E Biology (Basel). 2024; 13(9).

PMID: 39336155 PMC: 11428972. DOI: 10.3390/biology13090728.

Efficacy of Supra-HFR in Removing FGF23 and Cytokines: A Single Session Analysis.

Donati G, Angeletti A, Cappuccilli M, Donadei C, Guglielmo C, Scrivo A In Vivo. 2022; 36(4):1769-1776.

PMID: 35738602 PMC: 9301447. DOI: 10.21873/invivo.12890.

Research Progress of Fibroblast Growth Factor 21 in Fibrotic Diseases.

Jia M, Guan C, Tao J, Zhou Y Oxid Med Cell Longev. 2022; 2022:5042762.

PMID: 35677107 PMC: 9168133. DOI: 10.1155/2022/5042762.

Novel Iron Parameters in Patients with Type 2 Diabetes Mellitus in Relation to Kidney Function.

Zapora-Kurel A, Kuzma L, Zakrzewska M, Zorawski M, Dobrzycki S, Twardowska-Kawalec M J Clin Med. 2021; 10(16).

PMID: 34442028 PMC: 8397038. DOI: 10.3390/jcm10163732.

The Assessment of the Usefulness of Selected Markers in the Diagnosis of Chronic Kidney Disease in Children.

Bedzichowska A, Jobs K, Kloc M, Bujnowska A, Kalicki B Biomark Insights. 2021; 16:11772719211011173.

PMID: 33958853 PMC: 8060753. DOI: 10.1177/11772719211011173.

References

Scialla J, Xie H, Rahman M, Anderson A, Isakova T, Ojo A . Fibroblast growth factor-23 and cardiovascular events in CKD. J Am Soc Nephrol. 2013; 25(2):349-60. PMC: 3904568. DOI: 10.1681/ASN.2013050465. View

Rysz J, Gluba-Brzozka A, Mikhailidis D, Banach M . Fibroblast growth factor 19-targeted therapies for the treatment of metabolic disease. Expert Opin Investig Drugs. 2015; 24(5):603-10. DOI: 10.1517/13543784.2015.1006357. View

Gluba A, Banach M, Hannam S, Mikhailidis D, Sakowicz A, Rysz J . The role of Toll-like receptors in renal diseases. Nat Rev Nephrol. 2010; 6(4):224-35. DOI: 10.1038/nrneph.2010.16. View

. Autosomal dominant hypophosphataemic rickets is associated with mutations in FGF23. Nat Genet. 2000; 26(3):345-8. DOI: 10.1038/81664. View

Deger S, Erten Y, Pasaoglu O, Derici U, Reis K, Onec K . The effects of iron on FGF23-mediated Ca-P metabolism in CKD patients. Clin Exp Nephrol. 2012; 17(3):416-23. DOI: 10.1007/s10157-012-0725-0. View

Rysz J, Banach M, Cialkowska-Rysz A, Stolarek R, Barylski M, Drozdz J . Blood serum levels of IL-2, IL-6, IL-8, TNF-alpha and IL-1beta in patients on maintenance hemodialysis. Cell Mol Immunol. 2006; 3(2):151-4. View

Malyszko J, Koc-Zorawska E, Levin-Iaina N, Slotki I, Matuszkiewicz-Rowinska J, Glowinska I . Iron metabolism in hemodialyzed patients - a story half told?. Arch Med Sci. 2015; 10(6):1117-22. PMC: 4296069. DOI: 10.5114/aoms.2014.47823. View

Prats M, Font R, Garcia C, Cabre C, Jariod M, Martinez Vea A . Effect of ferric carboxymaltose on serum phosphate and C-terminal FGF23 levels in non-dialysis chronic kidney disease patients: post-hoc analysis of a prospective study. BMC Nephrol. 2013; 14:167. PMC: 3751040. DOI: 10.1186/1471-2369-14-167. View

Malyszko J, Koc-Zorawska E, Levin-Iaina N, Malyszko J, Kozminski P, Kobus G . New parameters in iron metabolism and functional iron deficiency in patients on maintenance hemodialysis. Pol Arch Med Wewn. 2012; 122(11):537-42. View

10.

Wolf M, White K . Coupling fibroblast growth factor 23 production and cleavage: iron deficiency, rickets, and kidney disease. Curr Opin Nephrol Hypertens. 2014; 23(4):411-9. PMC: 4322859. DOI: 10.1097/01.mnh.0000447020.74593.6f. View

11.

Razzaque M . Does FGF23 toxicity influence the outcome of chronic kidney disease?. Nephrol Dial Transplant. 2008; 24(1):4-7. PMC: 2721424. DOI: 10.1093/ndt/gfn620. View

12.

Isakova T, Wahl P, Vargas G, Gutierrez O, Scialla J, Xie H . Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011; 79(12):1370-8. PMC: 3134393. DOI: 10.1038/ki.2011.47. View

13.

Ix J, Katz R, Kestenbaum B, de Boer I, Chonchol M, Mukamal K . Fibroblast growth factor-23 and death, heart failure, and cardiovascular events in community-living individuals: CHS (Cardiovascular Health Study). J Am Coll Cardiol. 2012; 60(3):200-7. PMC: 3396791. DOI: 10.1016/j.jacc.2012.03.040. View

14.

Andrassy K . Comments on 'KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease'. Kidney Int. 2013; 84(3):622-3. DOI: 10.1038/ki.2013.243. View

15.

Franczyk-Skora B, Gluba A, Banach M, Rysz J . Treatment of non-ST-elevation myocardial infarction and ST-elevation myocardial infarction in patients with chronic kidney disease. Arch Med Sci. 2014; 9(6):1019-27. PMC: 3902722. DOI: 10.5114/aoms.2013.39792. View

16.

Wolf M . Forging forward with 10 burning questions on FGF23 in kidney disease. J Am Soc Nephrol. 2010; 21(9):1427-35. DOI: 10.1681/ASN.2009121293. View

17.

Zahran N, Sayed A, William I, Mahmoud O, Sabry O, Rafaat M . Neutrophil apoptosis: impact of granulocyte macrophage colony stimulating factor on cell survival and viability in chronic kidney disease and hemodialysis patients. Arch Med Sci. 2014; 9(6):984-9. PMC: 3902719. DOI: 10.5114/aoms.2013.39789. View

18.

Farrow E, Yu X, Summers L, Davis S, Fleet J, Allen M . Iron deficiency drives an autosomal dominant hypophosphatemic rickets (ADHR) phenotype in fibroblast growth factor-23 (Fgf23) knock-in mice. Proc Natl Acad Sci U S A. 2011; 108(46):E1146-55. PMC: 3219119. DOI: 10.1073/pnas.1110905108. View

19.

Braithwaite V, Prentice A, Doherty C, Prentice A . FGF23 is correlated with iron status but not with inflammation and decreases after iron supplementation: a supplementation study. Int J Pediatr Endocrinol. 2012; 2012(1):27. PMC: 3523041. DOI: 10.1186/1687-9856-2012-27. View

20.

Beenken A, Mohammadi M . The FGF family: biology, pathophysiology and therapy. Nat Rev Drug Discov. 2009; 8(3):235-53. PMC: 3684054. DOI: 10.1038/nrd2792. View