Serum fibroblast growth factor-23 is associated with incident kidney disease

Casey M. Rebholz, Morgan E. Grams, Josef Coresh, Elizabeth Selvin, Lesley A. Inker, Andrew S. Levey, Paul L. Kimmel, Ramachandran S. Vasan, John H. Eckfeldt, Harold I. Feldman, Chi Yuan Hsu, Pamela L. Lutsey

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Fibroblast growth factor-23 is a bone-derived hormone that increases urinary phosphate excretion and inhibits hydroxylation of 25-hydroxyvitamin D. Recent studies suggest that fibroblast growth factor-23 may be an early biomarker of CKD progression. However, its role in kidney function decline in the general population is unknown. We assessed the relationship between baseline (1990-1992) serum levels of intact fibroblast growth factor-23 and incident ESRD in 13,448 Atherosclerosis Risk in Communities study participants (56.1% women, 74.7% white) followed until December 31, 2010. At baseline, the mean age of participants was 56.9 years and the mean eGFR was 97ml/min per 1.73m2. During amedian follow-up of 19 years, 267 participants (2.0%) developed ESRD. After adjustment for demographic characteristics, baseline eGFR, traditional CKD risk factors, and markers of mineral metabolism, the highest fibroblast growth factor-23 quintile (>54.6 pg/ml) compared with the lowest quintile (<32.0 pg/ml) was associated with risk of developing ESRD (hazard ratio, 2.10; 95% confidence interval, 1.31 to 3.36; trend P<0.001). In a large, community-based study comprising a broad range of kidney function, higher baseline fibroblast growth factor-23 levels were associated with increased risk of incident ESRD independent of the baseline level of kidney function and a number of other risk factors.

Original languageEnglish (US)
Pages (from-to)192-200
Number of pages9
JournalJournal of the American Society of Nephrology
Issue number1
StatePublished - Jan 1 2015

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Copyright © 2015 by the American Society of Nephrology.


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