ArticlePloS one2018
Phosphate control in reducing FGF23 levels in hemodialysis patients.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
21 citing papers in PubMed, 38 citations in OpenAlex.
- Predictive factors requiring high-dose evocalcet in hemodialysis patients with secondary hyperparathyroidism.PloS one · 2022Trial
- EOS789, a broad-spectrum inhibitor of phosphate transport, is safe with an indication of efficacy in a phase 1b randomized crossover trial in hemodialysis patients.Kidney international · 2021Trial
- Fibroblast Growth Factor 23 Trajectories in Chronic Hemodialysis Patients: Lessons from the HEMO Study.American journal of nephrology · 2019Trial
- The Promising Role of Selected Fibroblast Growth Factors as Potential Markers of Complications in Type 1 and Type 2 Diabetes.International journal of molecular sciences · 2025Article
- Article
- The true cost of phosphate control in chronic kidney disease.Clinical kidney journal · 2025Article
- Carotid intima-media thickness, fibroblast growth factor 23, and mineral bone disorder in children with chronic kidney disease.BMC nephrology · 2024Article
- The open system of FGF-23 at the crossroad between additional P-lowering therapy, anemia and inflammation: how to deal with the intact and the C-terminal assays?Clinical kidney journal · 2023Article
- Postdialysis serum phosphate equilibrium in hemodialysis patients on a controlled diet and no binders.Hemodialysis international. International Symposium on Home Hemodialysis · 2022Article
- Phosphate Balance and CKD-Mineral Bone Disease.Kidney international reports · 2021Review
- Review
- An Overview of FGF-23 as a Novel Candidate Biomarker of Cardiovascular Risk.Frontiers in physiology · 2021Review
- Sex Differences in Kidney Stone Disease in Chinese Patients with Type 2 Diabetes Mellitus.Kidney diseases (Basel, Switzerland) · 2020Article
- Clinical Potential of Targeting Fibroblast Growth Factor-23 and αKlotho in the Treatment of Uremic Cardiomyopathy.Journal of the American Heart Association · 2020Review
- CharXgen-Activated Bamboo Charcoal Encapsulated in Sodium Alginate Microsphere as the Absorbent of Uremic Toxins to Retard Kidney Function Deterioration.International journal of molecular sciences · 2020Article
- Efficacy and Safety of Evocalcet Evaluated by Dialysate Calcium Concentration in Patients with Secondary Hyperparathyroidism Undergoing Hemodialysis.International journal of nephrology and renovascular disease · 2020Article
- Imbalance of Th22/Treg cells causes microinflammation in uremic patients undergoing hemodialysis.Bioscience reports · 2019Article
- Review
- Phosphate, the forgotten mineral in hypertension.Current opinion in nephrology and hypertension · 2019Review
- FGF23, Biomarker or Target?Toxins · 2019Review
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn hemodialysis patients, high levels of Fibroblast Growth Factor 23 (FGF23) predict mortality. Our study was designed to test whether the control of serum phosphate is associated with a reduction in serum FGF23 levels. Additionally other variables with a potential effect on FGF23 levels were evaluated. MATERIAL AND
methodsThe effect of sustained (40-weeks) control of serum phosphate on FGF23 levels (intact and c-terminal) was evaluated in 21 stable hemodialysis patients that were not receiving calcimimetics or active vitamin D. Patients received non-calcium phosphate binders to maintain serum phosphate below 4.5 mg/dl. In an additional analysis, values of intact-FGF23 (iFGF23) and c-terminal FGF23 (cFGF23) from 150 hemodialysis patients were correlated with parameters of mineral metabolism and inflammation. Linear mixed models and linear regression were performed to evaluate longitudinal trajectories of variables and the association between FGF23 and the other variables examined.
resultsDuring the 40-week treatment, 12 of 21 patients achieved the target of serum phosphate <4.5 mg/dl. In these 12 patients, iFGF23 decreased to less than half whereas cFGF23 did not reduce significantly. In patients with serum phosphate >4.5 mg, iFGF23 and cFGF23 increased two and four-fold respectively as compared with baseline. Furthermore, changes in serum phosphate correlated with changes in C-reactive protein (hs-CRP). In our 150 hemodialysis patients, those in the higher tertile of serum phosphate also showed increased hs-CRP, iPTH, iFGF23 and cFGF23. Multiple regression analysis revealed that iFGF23 levels directly correlated with both serum phosphate and calcium, whereas cFGF23 correlated with serum phosphate and hs-CRP but not with calcium.
conclusionsThe control of serum phosphate reduced iFGF23. This reduction was also associated with a decreased in inflammatory parameters. Considering the entire cohort of hemodialysis patients, iFGF23 levels correlated directly with serum phosphate levels and also correlated inversely with serum calcium concentration. The levels of cFGF23 were closely related to serum phosphate and parameters of inflammation.
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