ArticleKidney medicine
Changes in Fibroblast Growth Factor 23 and Soluble Klotho Levels After Hemodialysis Initiation.
Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The trial behind it
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study.BMC nephrology · 2021Trial
- Chronic kidney disease as a potential risk factor for pituitary hormone dysregulation: a review of the underlying mechanisms.Molecular biology reports · 2026Review
- Impact of online hemodiafiltration on bone turnover in children with CKD-5d: A prospective cohort study.Pediatric nephrology (Berlin, Germany) · 2025Article
- Crosstalk between kidney and bone: insights from CKD-MBD.Journal of bone and mineral metabolism · 2024Review
- Roles of Parathyroid Hormone and Fibroblast Growth Factor 23 in Advanced Chronic Kidney Disease.Endocrinology and metabolism (Seoul, Korea) · 2024Review
- FGF23 and klotho at the intersection of kidney and cardiovascular disease.Nature reviews. Cardiology · 2024Review
- Roles of PTH and FGF23 in kidney failure: a focus on nonclassical effects.Clinical and experimental nephrology · 2023Review
- Fibroblast Growth Factor-23-Klotho Axis in Cardiorenal Syndrome: Mediators and Potential Therapeutic Targets.Frontiers in physiology · 2021Review
- Klotho Pathways, Myelination Disorders, Neurodegenerative Diseases, and Epigenetic Drugs.BioResearch open access · 2020Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
RATIONALE &
objectivePatients with chronic kidney failure have markedly elevated fibroblast growth factor 23 (FGF-23) levels and decreased soluble Klotho levels. However, no studies have examined the effects of hemodialysis initiation on the levels of these hormones and other parameters of mineral metabolism. STUDY
designProspective single-arm study. SETTING &
participants20 individuals with incident kidney failure initiating hemodialysis. EXPOSURE: Initiation of hemodialysis. Dose adjustments of phosphate binders and vitamin D receptor activators and use of calcimimetics, erythropoiesis-stimulating agents, and intravenous iron were prohibited. OUTCOMES: Changes in serum levels of FGF-23, soluble Klotho, and other biochemical parameters of mineral metabolism, measured before and after each hemodialysis session, for a total of 4 sessions over 5 days. ANALYTICAL APPROACH: Repeated-measures analysis of variance.
resultsAt baseline, participants had 18-fold higher median FGF-23 levels and 1.6-fold lower mean soluble Klotho levels compared with age- and sex-matched healthy individuals. Initiation of hemodialysis led to progressive reductions in serum phosphorus, intact parathyroid hormone, and FGF-23 levels, with dialysis-related fluctuations. No reductions were observed in levels of α LIMITATIONS: Single-arm design, small sample size, short follow-up period.
conclusionsInitiation of hemodialysis in patients with chronic kidney failure led to progressive reductions in FGF-23 levels in association with reductions in serum phosphorus levels. These results suggest that phosphorus is a strong inducer of FGF-23 production and that regulation of FGF-23 production is a rapid process.
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Registered trials
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