Association between serum fibroblast growth factor‐23 concentration and development of hyperphosphatemia in normophosphatemic dogs with chronic kidney disease

Abstract

Background Fibroblast growth factor (FGF)‐23 is increased first in the sequence of changes associated with chronic kidney disease (CKD)‐mineral and bone disorder. Thus, its measurement may serve as a predictive indicator of incident hyperphosphatemia. Objectives To investigate whether serum FGF‐23 concentration in normophosphatemic dogs with CKD is associated with the risk of the subsequent development of hyperphosphatemia and CKD progression. Animals Forty‐two normophosphatemic dogs with CKD. Methods Blood samples and medical records were retrospectively investigated. Hyperphosphatemia was defined as a serum phosphorous concentration >5.0 mg/dL. Progression was defined as a >1.5‐fold increase in serum creatinine concentration. The time periods and hazard ratios for these outcomes were assessed using Kaplan‐Meier analysis, log‐rank test, and univariate Cox regression analysis. The variables associated with the outcomes in the univariate analysis were included in the multivariate Cox regression model with backward selection. Results Serum FGF‐23 concentration >528 pg/mL was associated with a shorter time to development of hyperphosphatemia ( P < .001) and CKD progression ( P < .001). In multiple Cox regression analysis, increased FGF‐23 concentration remained a significant variable associated with these outcomes ( P < .05). Conclusions and Clinical Importance Increased FGF‐23 concentration in normophosphatemic dogs with CKD was associated with significant risk of development of hyperphosphatemia, independent of CKD stage, and of the progression of CKD. Future research focusing on whether interventions that decrease FGF‐23 secretion will slow the development of hyperphosphatemia and CKD progression is needed.

Blood fibroblast growth factor 23 concentration in cats with and without chronic kidney disease: a scoping review

“…A recent study of cats using the MedFrontier assay showed that FGF-23 was relatively stable within a 24 h period with no significant circadian rhythm or postprandial effect, supporting that the timing of sample collection is of little importance. 49 Documentation of the degree of day-to-day variability and the biological variation of FGF-23 concentration in cats is needed to better understand the potential use of FGF-23 measurement in clinical practice. Finally, our results are up to date only as of 31 December 2022, and additional studies investigating FGF-23 in the context of renal disease may have since become available.…”

Progress of Wnt Signaling Pathway in Osteoporosis

“…FGF-23 participates in osteogenic differentiation through binding and activating tyrosine kinase receptors on the cell surface. The effect of FGF-23 on osteogenic differentiation is related to the concentration of FGF-23 [ 83 ]. When the concentration of FGF is too high or too low, it will affect normal bone development and bone metabolism [ 84 ].…”