Fibroblast Growth Factor-23 and Cardiovascular Disease in Chronic Kidney Disease

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Published: Sep 1, 2025
DOI: https://doi.org/10.63555/jnst.2025.279894
Keywords:
FGF-23 kidney failure dialysis mortality CVD cardiac hypertrophy

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Komchan Utamawatin
Division of Nephrology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
Bancha Satirapoj
Division of Nephrology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand

Abstract

Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD). Fibroblast growth factor 23 (FGF23) is a medium-sized uremic toxin that begins to accumulate as early as CKD stage 2, increasing progressively as glomerular filtration rate declines. This accumulation results from both increased production and reduced clearance of FGF23. The molecule binds to receptors on cardiac myocytes, triggering fibrotic signaling pathways that lead to myocardial hypertrophy and fibrosis. This cardiac remodeling heightens the risk of arrhythmias, heart failure, and cardiovascular mortality in CKD patients. Although significant progress has been made in understanding the regulation and biological actions of FGF23, effective treatments to reduce FGF23 levels or reverse cardiac remodeling remain limited. This article reviews the current understanding of FGF23 regulation and explores potential strategies to reduce its levels in order to improve cardiovascular outcomes in patients with CKD.

Article Details

How to Cite
Utamawatin, K., & Satirapoj, B. (2025). Fibroblast Growth Factor-23 and Cardiovascular Disease in Chronic Kidney Disease. Journal of the Nephrology Society of Thailand, 31(3), 208–219. https://doi.org/10.63555/jnst.2025.279894
Issue
Vol. 31 No. 3 (2025): July - September
Section
Review Article
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