Frontiers in Endocrinology (Jan 2023)

Fibroblast growth factor 23 is independently associated with renal magnesium handling in patients with chronic kidney disease

  • Teodora V. Grigore,
  • Malou Zuidscherwoude,
  • Anna Witasp,
  • Peter Barany,
  • Annika Wernerson,
  • Annette Bruchfeld,
  • Annette Bruchfeld,
  • Hong Xu,
  • Hannes Olauson,
  • Joost Hoenderop

DOI
https://doi.org/10.3389/fendo.2022.1046392
Journal volume & issue
Vol. 13

Abstract

Read online

BackgroundDisturbances in magnesium homeostasis are common in patients with chronic kidney disease (CKD) and are associated with increased mortality. The kidney is a key organ in maintaining normal serum magnesium concentrations. To this end, fractional excretion of magnesium (FEMg) increases as renal function declines. Despite recent progress, the hormonal regulation of renal magnesium handling is incompletely understood. Fibroblast Growth Factor 23 (FGF23) is a phosphaturic hormone that has been linked to renal magnesium handling. However, it has not yet been reported whether FGF23 is associated with renal magnesium handling in CKD patients.MethodsThe associations between plasma FGF23 levels, plasma and urine magnesium concentrations and FEMg was investigated in a cross-sectional cohort of 198 non-dialysis CKD patients undergoing renal biopsy.ResultsFGF23 was significantly correlated with FEMg (Pearson’s correlation coefficient = 0.37, p<0.001) and urinary magnesium (-0.14, p=0.04), but not with plasma magnesium. The association between FGF23 and FEMg remained significant after adjusting for potential confounders, including estimated glomerular filtration rate (eGFR), parathyroid hormone and 25-hydroxyvitamin D.ConclusionsWe report that plasma FGF23 is independently associated with measures of renal magnesium handling in a cohort of non-dialysis CKD patients. A potential causal relationship should be investigated in future studies.

Keywords