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Phosphorus Retention and Elevated FGF-23 in Chronic Kidney Disease

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Endocrine Disorders in Kidney Disease

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Abstract

Cardiovascular disease is a major cause of morbidity and mortality in patients with chronic kidney disease (CKD), especially in those with end-stage renal disease (ESRD), and the risk of cardiovascular mortality is 10–20-fold higher among hemodialysis patients. However, some of the traditional risk factors of cardiovascular disease such as African-American race, hypertension, hypercholesterolemia, and obesity are paradoxically associated with better outcomes in CKD and ESRD patients, and these observations point to the presence of novel cardiovascular risk factors in CKD. In addition to the fact that decreased kidney function itself is a strong and independent predictor of cardiovascular events, CKD is characterized by a complex metabolic milieu that consists of multiple biochemical and hormonal abnormalities. Those abnormalities in mineral and bone metabolism have also been associated with worse cardiovascular outcomes and mortality independent of traditional risk factors. These findings have led to the emergence of a framework termed CKD-related mineral and bone disorders (CKD-MBD).

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Department of Medicine, University of California Irvine School of Medicine, Orange, CA, USA

    Yoshitsugu Obi

  2. Division of Nephrology and Hypertension, Departments of Medicine and Public Health, University of California Irvine School of Medicine, Orange, CA, USA

    Connie M. Rhee

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  1. Yoshitsugu Obi
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  2. Connie M. Rhee
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Correspondence to Connie M. Rhee .

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Editors and Affiliations

  1. Division of Nephrology and Hypertension, Departments of Medicine and Public Health, University of California Irvine, School of Medicine, Orange, CA, USA

    Connie M. Rhee

  2. Division of Nephrology and Hypertension, Departments of Medicine, Pediatrics, Public Health, and Nursing Sciences, University of California Irvine, School of Medicine, Orange, CA, USA

    Kamyar Kalantar-Zadeh

  3. Division of Endocrinology, Diabetes, and Hypertension, Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Gregory A. Brent

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Obi, Y., Rhee, C.M. (2019). Phosphorus Retention and Elevated FGF-23 in Chronic Kidney Disease. In: Rhee, C., Kalantar-Zadeh, K., Brent, G. (eds) Endocrine Disorders in Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-97765-2_15

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