الفهرس 
Fibroblast Growth Factor 23 (FGF23)
FGF23 associated to chronic kidney diseaseOnly 14 pages are availabe for public view
 |  | from | 173 |  |  |
| | | from | 173 | | |
Abstract
FGF23 is free circulating endocrine hormone which
Secreted by osteocytes. FGF23 affect phosphate
metabolism mainly as it inhibits renal tubular phosphat
reabsorption by suppressing the expression of luminal
sodium– phosphate co-transporters (NaPi).
Increased FGF23 is independently associated with
arterial stiffness, endothelial dysfunction and increased
ventricular mass through direct activation of GF23 receptor
present in cardiac tissue and this action is Koltho
independent because Koltho co receptor not expressed in
myocardial cell
After renal transplantation the residual FGF23
activity may also contribute to early post-transplant
hypophosphatemia, which could in turn play a role in the
pathogenesis of post-transplant bone disease.
Post-transplantation hypophosphataemia can have a
detrimental effect on bone mineralization and might
contribute to impaired osteoblast genesis and early
osteoblast apoptosis, which further contributes to posttransplantation osteoporosis.Data from bone biopsies obtained from renal
transplant recipients after transplantation have shown that
serum phosphate levels are lower in patients with early
osteoblast apoptosis, with serum phosphate levels
correlating positively with osteoblast number and
correlating negatively with the number of apoptotic
osteoblasts.
Also high FGF-23 levels were associated with a
reduction in BMD in the lumbar spine and total hip regions
during the first year post-transplantation.
As a result disorders of FGF-23 excess are
characterized by hypophosphatemia with increased renal
phosphate wasting, decreased production of 1, 25(OH) 2D,
elevated parathyroid hormone and rickets ⁄ osteomalacia
after renal transplantation.
In our study, Patients on dialysis had higher levels of
FGF23, phosphorous, PTH and low levels of Calcium in
compare with preemptive patient before renal
transplantation.
Also there was a significant decline in the level of
creatinine, urea, K, and hemoglobin after renal
transplantation in both group.Also in our study Circulating FGF23 values declined
rapidly in all patients with a functioning allograft, with (p
value <0.001).
Also In our study, mean iPTH levels decreased
sharply at 7 day post transplantation in both group with (p
value <0.001) in dialysis group & also with (p value
<0.001) in preemptive group.
Also In our study mean phosphorus levels
decreased at 7 day post transplantation in both group with
statistical significance (5.6±1.2to 2.8±0.5) in dialysis
patient.
Also In our study serum calcium level increased with
statistical significance in preemptive group.
The suggest further Studies on FGF23 function and
regulation will help to establish a more rational approach
for the management of the mineral and bone disorders.