Role of Circulating Fibroblast Growth Factor 23 in the Development of Secondary Hyperparathyroidism
Version of Record online: 19 JUL 2005
Therapeutic Apheresis and Dialysis
Volume 9, Issue 4, pages 328–330, August 2005
How to Cite
Kazama, J. J., Gejyo, F., Shigematsu, T. and Fukagawa, M. (2005), Role of Circulating Fibroblast Growth Factor 23 in the Development of Secondary Hyperparathyroidism. Therapeutic Apheresis and Dialysis, 9: 328–330. doi: 10.1111/j.1744-9987.2005.00291.x
- Issue online: 19 JUL 2005
- Version of Record online: 19 JUL 2005
- Received March 2005.
- Calcitriol therapy;
- Fibroblast growth factor 23 (FGF23);
- Intact parathyroid hormone (iPTH);
- Secondary hyperparathyroidism
Abstract: It would be useful to predict the future development of hyperparathyroidism before treatment with active vitamin D agents. Fibroblast growth factor 23 (FGF23) is a newly identified humoral phosphaturic factor. Positive correlation was found between parathyroid function and serum FGF23 levels in dialysis patients. Interestingly, FGF23 levels showed even better correlation with intact parathyroid hormone (iPTH) levels 2 years after the sample collection for the FGF23 measurement. In long-term dialysis patients with mild secondary hyperparathyroidism, serum FGF23 level was the best screening test to discriminate patients with future advanced secondary hyperparathyroidism within 2 years. In dialysis patients with advanced secondary hyperparathyroidism, the pretreatment FGF23 levels, as well as iPTH levels, significantly affected the outcome of calcitriol therapy. Thus, the measurement of serum FGF23 level is a promising laboratory examination to predict the future development of secondary hyperparathyroidism. The mechanism of this phenomenon, however, remains to be revealed.