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Fibroblast growth factor-23 and mineral metabolism after unilateral nephrectomy.
Nephrol Dial Transplant. 2010 Dec; 25(12):4068-71.ND

Abstract

BACKGROUND

Fibroblast growth factor -23 (FGF-23) is a key regulator of mineral metabolism. It regulates renal phosphate (Pi) reabsorption and calcitriol synthesis, and has an inhibitory effect on parathyroid hormone (PTH) secretion. FGF-23 increases early in chronic kidney disease (CKD), but the regulation of FGF-23 in mild -to -moderate renal dysfunction is not fully understood.

METHODS

Nine healthy kidney donors underwent unilateral nephrectomy. Estimated glomerular filtration rate (eGFR) calculated from cystatin C and parameters of mineral metabolism: (Pi, ionized calcium, biointact PTH, intact FGF-23, calcitriol, and urinary excretion of calcium and Pi) were analysed before surgery, and one day, one week and three to six months after surgery.

RESULTS

On the first post-operative day, PTH increased due to a decrease in the calcium level. One week after nephrectomy, the FGF-23 level increased from 31.8 ± 12.3 pg/mL to 55.8 ± 15.1 pg/mL, while PTH, Pi and calcium levels were unchanged compared towith baseline. On follow-up, eGFR improved compared with its one-week value, and PTH and FGF-23 were unchanged compared towith baseline. The calcitriol level decreased but was in the normal range at all points in time. The total amount of Pi in urine did not change, while the calcium excretion decreased significantly.

CONCLUSIONS

Pi homeostasis after nephrectomy is maintained by PTH on the first day. When serum calcium is stabilized and food intake resumed, FGF-23 rises, possibly in response to the Pi- load in relation to GFR.

Authors+Show Affiliations

Department of Medical Sciences, Uppsala University Hospital, Ing. 30, 5 tr.; UAS, 75185 Uppsala, Sweden. per-anton.westerberg@medsci.uu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20525976

Citation

Westerberg, Per-Anton, et al. "Fibroblast Growth Factor-23 and Mineral Metabolism After Unilateral Nephrectomy." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 25, no. 12, 2010, pp. 4068-71.
Westerberg PA, Ljunggren O, Larsson TE, et al. Fibroblast growth factor-23 and mineral metabolism after unilateral nephrectomy. Nephrol Dial Transplant. 2010;25(12):4068-71.
Westerberg, P. A., Ljunggren, O., Larsson, T. E., Wadström, J., & Linde, T. (2010). Fibroblast growth factor-23 and mineral metabolism after unilateral nephrectomy. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 25(12), 4068-71. https://doi.org/10.1093/ndt/gfq288
Westerberg PA, et al. Fibroblast Growth Factor-23 and Mineral Metabolism After Unilateral Nephrectomy. Nephrol Dial Transplant. 2010;25(12):4068-71. PubMed PMID: 20525976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fibroblast growth factor-23 and mineral metabolism after unilateral nephrectomy. AU - Westerberg,Per-Anton, AU - Ljunggren,Osten, AU - Larsson,Tobias E, AU - Wadström,Jonas, AU - Linde,Torbjörn, Y1 - 2010/06/04/ PY - 2010/6/8/entrez PY - 2010/6/8/pubmed PY - 2011/4/19/medline SP - 4068 EP - 71 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 25 IS - 12 N2 - BACKGROUND: Fibroblast growth factor -23 (FGF-23) is a key regulator of mineral metabolism. It regulates renal phosphate (Pi) reabsorption and calcitriol synthesis, and has an inhibitory effect on parathyroid hormone (PTH) secretion. FGF-23 increases early in chronic kidney disease (CKD), but the regulation of FGF-23 in mild -to -moderate renal dysfunction is not fully understood. METHODS: Nine healthy kidney donors underwent unilateral nephrectomy. Estimated glomerular filtration rate (eGFR) calculated from cystatin C and parameters of mineral metabolism: (Pi, ionized calcium, biointact PTH, intact FGF-23, calcitriol, and urinary excretion of calcium and Pi) were analysed before surgery, and one day, one week and three to six months after surgery. RESULTS: On the first post-operative day, PTH increased due to a decrease in the calcium level. One week after nephrectomy, the FGF-23 level increased from 31.8 ± 12.3 pg/mL to 55.8 ± 15.1 pg/mL, while PTH, Pi and calcium levels were unchanged compared towith baseline. On follow-up, eGFR improved compared with its one-week value, and PTH and FGF-23 were unchanged compared towith baseline. The calcitriol level decreased but was in the normal range at all points in time. The total amount of Pi in urine did not change, while the calcium excretion decreased significantly. CONCLUSIONS: Pi homeostasis after nephrectomy is maintained by PTH on the first day. When serum calcium is stabilized and food intake resumed, FGF-23 rises, possibly in response to the Pi- load in relation to GFR. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/20525976/Fibroblast_growth_factor_23_and_mineral_metabolism_after_unilateral_nephrectomy_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfq288 DB - PRIME DP - Unbound Medicine ER -