ReviewNature reviews. Cardiology2024
FGF23 and klotho at the intersection of kidney and cardiovascular disease.
Review in Nature reviews. Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
91 citing papers in PubMed, 2 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Physical exercise and circulating α-Klotho in humans: a systematic review and meta-analysis with emphasis on older adults.Frontiers in sports and active living · 2026Pooled it
- FGF-23 as a Biomarker for Carotid Plaque Vulnerability: A Systematic Review.Medical sciences (Basel, Switzerland) · 2025Pooled it
- Effects of Dapagliflozin on the Bone of Patients with CKD on Dialysis.Calcified tissue international · 2026Trial
- Exercise attenuates bed rest-induced increases in insulin resistance while α-klotho increases in 55 to 65 year-old women and men.Scientific reports · 2025Trial
- Biomaterials at the interface of bone-derived factors and inter-organ communication: Current evidence and future perspectives.Bioactive materials · 2026Review
- Changes of serum fibroblast growth factor 23 (FGF23) and Klotho in diabetic kidney disease and their correlation with coronary artery calcification: a retrospective study.Archives of endocrinology and metabolism · 2026Article
- Article
- Trained Immunity as a Mechanistic Bridge Between Uremic Toxins, Atherosclerosis, and Vascular Calcification in Chronic Kidney Disease.Cardiovascular toxicology · 2026Review
- Role of fibroblast growth factor-23 in renal disease activity and bone density involvement in patients with lupus nephritis.World journal of nephrology · 2026Article
- Characterization of Umbilical Cord Mesenchymal Stromal Cells Overexpressing Klotho and In Vitro Anti-Aging Efficacy of Their Derived Extracellular Vesicles.International journal of molecular sciences · 2026Article
- Pharmaceutical Strategies for Translating Klotho-Based Therapeutics: From Biologic Developability to Advanced Delivery Systems.Pharmaceutics · 2026Review
- The Heart-Kidney Axis in Heart Failure and Chronic Kidney Disease: Mechanisms, Mediators, and Therapeutic Implications.Biomolecules · 2026Review
- Italian guidelines for the management of adult individuals with post-surgical hypoparathyroidism.Journal of endocrinological investigation · 2026Article
- Systemic versus local regulation of vitamin D.Current opinion in nephrology and hypertension · 2026Review
- Pre-transplant and persistent post-transplant hyperparathyroidism and kidney transplant outcomes: a systematic review and meta-analysis.Clinical kidney journal · 2026Article
- Klotho in the kidney distal convolution regulates urinary Klotho excretion and kidney calcium reabsorption, but not phosphate homeostasis.Kidney international · 2026Article
- Serum Klotho Levels and Major Age-Related Ocular Disorders: A Cross-Sectional and Genetic Association Study.Translational vision science & technology · 2026Article
- Research progress on blood therapy for anti-aging.Journal of advanced research · 2026Review
- FGF23 Controls Myocardial Fibrosis Progression via Promoting Cardiac Fibroblast Proliferation and Activation in Mice.Biology · 2026Article
- Antiaging Properties of the Klotho Protein.Cells · 2026Review
31 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD). As CKD progresses, CKD-specific risk factors, such as disordered mineral homeostasis, amplify traditional cardiovascular risk factors. Fibroblast growth factor 23 (FGF23) regulates mineral homeostasis by activating complexes of FGF receptors and transmembrane klotho co-receptors. A soluble form of klotho also acts as a 'portable' FGF23 co-receptor in tissues that do not express klotho. In progressive CKD, rising circulating FGF23 levels in combination with decreasing kidney expression of klotho results in klotho-independent effects of FGF23 on the heart that promote left ventricular hypertrophy, heart failure, atrial fibrillation and death. Emerging data suggest that soluble klotho might mitigate some of these effects via several candidate mechanisms. More research is needed to investigate FGF23 excess and klotho deficiency in specific cardiovascular complications of CKD, but the pathophysiological primacy of FGF23 excess versus klotho deficiency might never be precisely resolved, given the entangled feedback loops that they share. Therefore, randomized trials should prioritize clinical practicality over scientific certainty by targeting disordered mineral homeostasis holistically in an effort to improve cardiovascular outcomes in patients with CKD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.