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Int Urol Nephrol. 2019 Mar;51(3):503-507. doi: 10.1007/s11255-019-02079-4. Epub 2019 Jan 28.

Relationship between cFGF23/Klotho ratio and phosphate levels in patients with chronic kidney disease.

Liu Z1,2, Zhou H3, Chen X3, Chen H3, Wang Y1,2, Wang T1,2, Cai L1,2, Hong Y1,2, Ke H1,2, Zheng J4.

Author information

1
Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, Fujian, People's Republic of China.
2
Department of Nephropathy, The People's Hospital of Fujian Province, Fuzhou, 350004, Fujian, People's Republic of China.
3
The People's Hospital of Fujian Province, Fuzhou, 350004, Fujian, People's Republic of China.
4
The People's Hospital of Fujian Province, Fuzhou, 350004, Fujian, People's Republic of China. zhengjing196402@outlook.com.

Abstract

PURPOSE:

To characterize the relationship between the cFGF23/Klotho ratio and phosphate level in patients with chronic kidney disease (CKD).

METHODS:

A total of 152 patients with CKD stage 3-5 (CKD stage 3: n = 74; CKD stage 4: n = 60; CKD stage 5: n = 18) were included in the study. Thirty healthy volunteers served as controls. Intact-FGF23, cFGF23, Klotho, serum calcium, serum phosphate, and serum creatinine were measured, and estimated glomerular filtration rate (eGFR) was calculated. The Kruskal-Wallis H test was used for comparison between groups, and the Spearman test was used for correlation analysis.

RESULTS:

In CKD stage 3-5, creatinine and iFGF23 levels, as well as the cFGF23/Klotho ratio, were higher (P < 0.01), phosphate levels were higher (P < 0.05), and Klotho levels were lower (P < 0.01), compared with controls. C-terminal-FGF23 levels were higher in CKD phase 4-5 (P < 0.05). In CKD stage 4-5, creatinine, iFGF23, and phosphate levels, as well as the cFGF23/Klotho ratio, were higher (P < 0.01), cFGF23 levels were higher (P < 0.05), and Klotho levels were lower (P < 0.05), compared with CKD stage 3. In CKD stage 5, creatinine and cFGF23 levels, as well as the cFGF23/Klotho ratio, were higher (P < 0.01), phosphate and iFGF23 levels were higher (P < 0.05), and Klotho levels were lower (P < 0.01), compared with CKD stage 4. Phosphate was positively correlated with the cFGF23/Klotho ratio (r = 0.235, P < 0.01).

CONCLUSIONS:

EGFR reduction was associated with an increased cFGF23/Klotho ratio, and the cFGF23/Klotho ratio was positively correlated with phosphate. This suggests that the phosphate level can be controlled by modifying the cFGF23/Klotho ratio.

KEYWORDS:

CKD; Klotho; Serum phosphate; cFGF23/Klotho ratio; iFGF23–Klotho signaling axis

PMID:
30689182
DOI:
10.1007/s11255-019-02079-4

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