ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018
FGF23-klotho axis, bone fractures, and arterial stiffness in dialysis: a case-control study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Circulating α-Klotho and Multidimensional Aging and Frailty Outcomes: A Systematic Review and Meta-Analysis from the European Renal Association CKD-MBD Working Group.Calcified tissue international · 2026Pooled it
- Correlation between soluble klotho and chronic kidney disease-mineral and bone disorder in chronic kidney disease: a meta-analysis.Scientific reports · 2024Pooled it
- [Effect of Ronghuang Granule on serum FGF23, FGFRs and Klotho in non-dialysis patients with CKD-MBD and kidney deficiency and damp-heat syndrome].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2018Trial
- The FGF23/α-Klotho Axis in Postmenopausal Osteoporosis: Associations with Bone Mineral Density and Diagnostic Discrimination.Journal of clinical medicine · 2026Article
- Association between serum α-Klotho levels and mortality in US adults with osteoporosis.BMC public health · 2025Article
- Interaction Effect of Estimated Pulse Wave Velocity and Serum Klotho Level on Chronic Kidney Disease.Aging medicine (Milton (N.S.W)) · 2025Article
- Klotho reduces the risk of osteoporosis in postmenopausal women: a cross-sectional study of the National Health and Nutrition Examination Survey (NHANES).BMC endocrine disorders · 2023Article
- Wnt/β-catenin pathway inhibitors, bone metabolism and vascular health in kidney transplant patients.Journal of nephrology · 2023Observational
- Type 2 diabetes and bone fragility in children and adults.World journal of diabetes · 2022Review
- FGF23-Klotho Axis and Fractures in Patients Without and With Early CKD: A Case-Cohort Analysis of CARTaGENE.The Journal of clinical endocrinology and metabolism · 2022Article
- Bone Marrow Adiposity, Bone Mineral Density and Wnt/β-catenin Pathway Inhibitors Levels in Hemodialysis Patients.Journal of bone metabolism · 2022Article
- Vitamin D Analogues and Fracture Risk in Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.JBMR plus · 2022Article
- Fibroblast Growth Factor 23 and Osteoporosis: Evidence from Bench to Bedside.International journal of molecular sciences · 2022Review
- No significant association of serum klotho concentration with blood pressure and pulse wave velocity in a Chinese population.Scientific reports · 2021Article
- Fibroblast Growth Factor-23-Klotho Axis in Cardiorenal Syndrome: Mediators and Potential Therapeutic Targets.Frontiers in physiology · 2021Review
- Understanding the Stony Bridge between Osteoporosis and Vascular Calcification: Impact of the FGF23/Klotho axis.Oxidative medicine and cellular longevity · 2021Review
- Understanding Bone Disease in Patients with Diabetic Kidney Disease: a Narrative Review.Current osteoporosis reports · 2020Review
- Vertebral fracture is associated with myocardial infarction in incident hemodialysis patients: a Korean nationwide population-based study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Significance of acPWV for Survival of Hemodialysis Patients.Medicina (Kaunas, Lithuania) · 2020Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
We performed a case-control study on 130 age- and sex-matched hemodialysis patients. In multivariate analysis, we observed that FGF23 levels were associated with fracture incidence and that soluble α-klotho levels were associated with the aortic-brachial arterial stiffness ratio.
introductionNew bone markers such as sclerostin, Dickkopf-related protein 1 (DKK1), fibroblast growth factor-23 (FGF23), and α-klotho have been identified as potential key players in bone and vascular abnormalities of chronic kidney disease. Therefore, we aimed to assess whether these markers are associated with fractures, bone metabolism, and vascular stiffness in dialysis patients.
methodsIn a prospective hemodialysis cohort, where plasma samples and vascular assessment were performed at baseline, we matched patients who experienced a fracture during follow-up with sex- and age-matched non-fractured patients on a 1:4 ratio. Sclerostin, DKK1, α-klotho, FGF23, and markers of bone formation (alkaline phosphatase and procollagen type 1-N terminal propeptide [P1NP]) and bone resorption (tartrate-resistant acid phosphatase 5b [TRAP5b]) were measured in baseline plasma samples. Aortic-brachial pulse wave velocity ratio, a blood pressure independent measure of arterial stiffness, was used to assess vascular stiffness at baseline.
resultsWe included 130 hemodialysis patients (26 fractured, 104 non-fractured) with a median follow-up of 42 months and a median age of 72 years. In multivariate Cox regression models, high FGF23 levels were associated with increased fracture incidence (adjusted HR = 2.97; 95% CI 1.18, 7.43). α-Klotho levels were associated with bone formation but not resorption markers. In both univariate and multivariable adjusted models, α-klotho levels were inversely associated with the aortic-brachial pulse wave velocity ratio (β = - 0.070; 95% CI - 0.133, - 0.006).
conclusionsThese results suggest a role for FGF23/klotho axis on bone and vascular metabolism in dialysis populations.
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