Department of Nephrology, Aristotle University of Thessaloniki, General Hospital "Hippokratio", Thessaloniki, Greece.
Curr Vasc Pharmacol. 2021;19(1):55-62. doi: 10.2174/1570161118666200420102100.
Alterations of fibroblast growth factor 23 (FGF-23) and Klotho levels are considered to be the earliest biochemical abnormality of chronic kidney disease - mineral and bone disease (CKDMBD) syndrome. Moreover, emerging data suggests that the dysregulated FGF-23 and Klotho axis has many effects on the cardiovascular (CV) system and contributes significantly to the increased CV morbidity and mortality rates of CKD patients. This review examines recent evidence on the role of FGF-23 and Klotho in the development and progression of CV complications of uremia namely cardiac hypertrophy, uremic cardiomyopathy, and atherosclerotic and arteriosclerotic vascular lesions. Moreover, the available evidence on their associations with adverse clinical outcomes are summarized. Undoubtedly, more studies are needed to further elucidate the effects of FGF-23 and Klotho on the heart and vessels and to gain insights into their prognostic value as CV risk factors. Finally, large prospective studies are required to test the hypothesis that modification of their levels would have a favourable impact on the unacceptably high mortality rates of these patient populations.
成纤维细胞生长因子 23（FGF-23）和 Klotho 水平的改变被认为是慢性肾脏病-矿物质和骨异常（CKDMBD）综合征最早的生化异常。此外，新出现的数据表明，失调的 FGF-23 和 Klotho 轴对心血管（CV）系统有许多影响，并显著导致 CKD 患者的 CV 发病率和死亡率增加。这篇综述检查了最近的证据，研究了 FGF-23 和 Klotho 在尿毒症心血管并发症（即心脏肥大、尿毒症性心肌病和动脉粥样硬化和动脉硬化血管病变）的发展和进展中的作用。此外，还总结了它们与不良临床结局的相关性的现有证据。毫无疑问，需要更多的研究来进一步阐明 FGF-23 和 Klotho 对心脏和血管的影响，并深入了解它们作为心血管危险因素的预后价值。最后，需要进行大型前瞻性研究来检验这样一种假设，即改变它们的水平将对这些患者群体不可接受的高死亡率产生有利影响。
