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Total parathyroidectomy reduces elevated circulating fibroblast growth factor 23 in advanced secondary hyperparathyroidism.
Am J Kidney Dis. 2004 Sep; 44(3):481-7.AJ

Abstract

BACKGROUND

Secondary hyperparathyroidism is a common complication in patients with stage 5 chronic kidney disease (CKD), accelerated by hyperphosphatemia. Fibroblast growth factor 23 (FGF-23), a phosphorus-regulating protein, has key roles in several phosphate-wasting disorders. The aim of this study is to examine the association of advanced secondary hyperparathyroidism with circulating FGF-23 levels.

METHODS

Fifteen patients with marked secondary hyperparathyroidism (parathyroid hormone [PTH], 990 +/- 118 pg/mL [ng/L]) were enrolled. All underwent parathyroidectomy with forearm autotransplantation (PTX), and their FGF-23 levels were measured before and after PTX (days 1, 3, 7, and 10) by means of sandwich enzyme-linked immunosorbent assay.

RESULTS

Preoperative FGF-23 levels correlated positively with phosphorus (P < 0.05), calcium-phosphorus product (Ca x P; P < 0.0005), and PTH values (P < 0.05). Serum FGF-23 levels decreased time dependently after PTX (P < 0.0005). Both serum phosphorus and Ca x P values decreased similarly after PTX (P = 0.0001). Furthermore, FGF-23 levels days 1 and 3 correlated linearly with serum phosphorus (P < 0.05; P < 0.005, respectively) and Ca x P values (P < 0.01; P < 0.0001, respectively).

CONCLUSION

FGF-23 levels correlate positively with serum phosphorus, Ca x P, and PTH values in patients with advanced secondary hyperparathyroidism. Complete ablation of progressive parathyroid glands reduces circulating FGF-23 levels, simultaneously decreasing serum phosphorus and Ca x P values. These findings suggest that hyperplastic parathyroid glands, together with hyperphosphatemia, affect abnormal FGF-23 metabolism in patients with stage 5 CKD with advanced secondary hyperparathyroidism.

Authors+Show Affiliations

Department of Surgery, Renal Center, Nagoya Second Red Cross Hospital, Nagoya, Japan. tetsugar@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15332221

Citation

Sato, Tetsuhiko, et al. "Total Parathyroidectomy Reduces Elevated Circulating Fibroblast Growth Factor 23 in Advanced Secondary Hyperparathyroidism." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 44, no. 3, 2004, pp. 481-7.
Sato T, Tominaga Y, Ueki T, et al. Total parathyroidectomy reduces elevated circulating fibroblast growth factor 23 in advanced secondary hyperparathyroidism. Am J Kidney Dis. 2004;44(3):481-7.
Sato, T., Tominaga, Y., Ueki, T., Goto, N., Matsuoka, S., Katayama, A., Haba, T., Uchida, K., Nakanishi, S., Kazama, J. J., Gejyo, F., Yamashita, T., & Fukagawa, M. (2004). Total parathyroidectomy reduces elevated circulating fibroblast growth factor 23 in advanced secondary hyperparathyroidism. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 44(3), 481-7.
Sato T, et al. Total Parathyroidectomy Reduces Elevated Circulating Fibroblast Growth Factor 23 in Advanced Secondary Hyperparathyroidism. Am J Kidney Dis. 2004;44(3):481-7. PubMed PMID: 15332221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Total parathyroidectomy reduces elevated circulating fibroblast growth factor 23 in advanced secondary hyperparathyroidism. AU - Sato,Tetsuhiko, AU - Tominaga,Yoshihiro, AU - Ueki,Tsuneo, AU - Goto,Norihiko, AU - Matsuoka,Susumu, AU - Katayama,Akio, AU - Haba,Toshihito, AU - Uchida,Kazuharu, AU - Nakanishi,Shohei, AU - Kazama,Junichiro James, AU - Gejyo,Fumitake, AU - Yamashita,Takeyoshi, AU - Fukagawa,Masafumi, PY - 2004/8/28/pubmed PY - 2005/2/24/medline PY - 2004/8/28/entrez SP - 481 EP - 7 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 44 IS - 3 N2 - BACKGROUND: Secondary hyperparathyroidism is a common complication in patients with stage 5 chronic kidney disease (CKD), accelerated by hyperphosphatemia. Fibroblast growth factor 23 (FGF-23), a phosphorus-regulating protein, has key roles in several phosphate-wasting disorders. The aim of this study is to examine the association of advanced secondary hyperparathyroidism with circulating FGF-23 levels. METHODS: Fifteen patients with marked secondary hyperparathyroidism (parathyroid hormone [PTH], 990 +/- 118 pg/mL [ng/L]) were enrolled. All underwent parathyroidectomy with forearm autotransplantation (PTX), and their FGF-23 levels were measured before and after PTX (days 1, 3, 7, and 10) by means of sandwich enzyme-linked immunosorbent assay. RESULTS: Preoperative FGF-23 levels correlated positively with phosphorus (P < 0.05), calcium-phosphorus product (Ca x P; P < 0.0005), and PTH values (P < 0.05). Serum FGF-23 levels decreased time dependently after PTX (P < 0.0005). Both serum phosphorus and Ca x P values decreased similarly after PTX (P = 0.0001). Furthermore, FGF-23 levels days 1 and 3 correlated linearly with serum phosphorus (P < 0.05; P < 0.005, respectively) and Ca x P values (P < 0.01; P < 0.0001, respectively). CONCLUSION: FGF-23 levels correlate positively with serum phosphorus, Ca x P, and PTH values in patients with advanced secondary hyperparathyroidism. Complete ablation of progressive parathyroid glands reduces circulating FGF-23 levels, simultaneously decreasing serum phosphorus and Ca x P values. These findings suggest that hyperplastic parathyroid glands, together with hyperphosphatemia, affect abnormal FGF-23 metabolism in patients with stage 5 CKD with advanced secondary hyperparathyroidism. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/15332221/Total_parathyroidectomy_reduces_elevated_circulating_fibroblast_growth_factor_23_in_advanced_secondary_hyperparathyroidism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272638604008170 DB - PRIME DP - Unbound Medicine ER -