FGF23 and Associated Disorders of Phosphate Wasting

dc.contributor.authorGohil, Anisha
dc.contributor.authorImel, Erik A.
dc.contributor.departmentPediatrics, School of Medicineen_US
dc.date.accessioned2021-05-28T22:53:57Z
dc.date.available2021-05-28T22:53:57Z
dc.date.issued2019-09-01
dc.description.abstractFibroblast growth factor 23 (FGF23), one of the endocrine fibroblast growth factors, is a principal regulator in the maintenance of serum phosphorus concentration. Binding to its cofactor αKlotho and a fibroblast growth factor receptor is essential for its activity. Its regulation and interaction with other factors in the bone-parathyroid-kidney axis is complex. FGF23 reduces serum phosphorus concentration through decreased reabsorption of phosphorus in the kidney and by decreasing 1,25 dihydroxyvitamin D (1,25(OH)2D) concentrations. Various FGF23-mediated disorders of renal phosphate wasting share similar clinical and biochemical features. The most common of these is X-linked hypophosphatemia (XLH). Additional disorders of FGF23 excess include autosomal dominant hypophosphatemic rickets, autosomal recessive hypophosphatemic rickets, fibrous dysplasia, and tumor-induced osteomalacia. Treatment is challenging, requiring careful monitoring and titration of dosages to optimize effectiveness and to balance side effects. Conventional therapy for XLH and other disorders of FGF23-mediated hypophosphatemia involves multiple daily doses of oral phosphate salts and active vitamin D analogs, such as calcitriol or alfacalcidol. Additional treatments may be used to help address side effects of conventional therapy such as thiazides to address hypercalciuria or nephrocalcinosis, and calcimimetics to manage hyperparathyroidism. The recent development and approval of an anti-FGF23 antibody, burosumab, for use in XLH provides a novel treatment option.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationGohil, A., & Imel, E. A. (2019). FGF23 and Associated Disorders of Phosphate Wasting. Pediatric Endocrinology Reviews : PER, 17(1), 17–34. https://doi.org/10.17458/per.vol17.2019.gi.fgf23anddisordersphosphateen_US
dc.identifier.issn1565-4753en_US
dc.identifier.urihttps://hdl.handle.net/1805/26067
dc.language.isoen_USen_US
dc.publisherYS Medical Mediaen_US
dc.relation.isversionof10.17458/per.vol17.2019.gi.fgf23anddisordersphosphateen_US
dc.relation.journalPediatric endocrinology reviews : PERen_US
dc.sourcePMCen_US
dc.subjectFGF23en_US
dc.subjectKlothoen_US
dc.subjectPhosphorusen_US
dc.subject1,25(OH)2Den_US
dc.subjectXLHen_US
dc.subjectBurosumaben_US
dc.subjectRicketsen_US
dc.titleFGF23 and Associated Disorders of Phosphate Wastingen_US
dc.typeArticleen_US
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