The role of fibroblast growth factor 23 in the assessment of complications in chronic kidney disease

Secondary hyperparathyroidism is an early-stage complication of CKD (Chronic Kidney Disease). It is associated with disorders in bone metabolism, calcium deposition in vessels and organs, significantly increased risk of cardiovascular disease, and death. In recent years, an increasingly important role has been attributed to fibroblast growth factor (FGF 23) in regulating calcium/phosphate homeostasis, hyperparathyroidism, and its relation to vascular calcification, and left ventricular hypertrophy. This study conducted with 110 patients with varying degrees of renal insufficiency shows an increase in FGF23 and PTH when there is a decrease in glomerular filtration, a direct dependency between the levels of phosphate and PTH and FGF23, and a lack of such between calcium and PTH and FGF23. Of particular interest is the fact that patients treated with Calcitriol and Paricalcitol show a reduction in PTH levels, yet maintain high levels of FGF23. PTH serves as a marker for the rate of bone remodeling in patients, where elevated levels indicate renal bone disease. The analysis of FGF 23 is crucial in evaluating cardiovascular risk.