Introduction

Among the family of fibroblast growth factors (FGFs), FGF19, FGF21, and FGF23 act as circulating hormones and are called endocrine FGFs. FGF19 and FGF21 regulate bile acid and energy homeostasis, respectively, whereas FGF23 regulates vitamin D and phosphate homeostasis. Accumulating evidence suggests that FGF23 plays a critical role in disturbed mineral metabolisms, left ventricular hypertrophy, immunosuppression, inflammation, among others in patients with chronic kidney disease (CKD), highlighting the potential both as a biomarker and a therapeutic target. Several studies have also examined the potential role of FGF19 and FGF21 in CKD patients.

Areas covered

In this review, we present a brief overview of the biology of FGF19, FGF21, and FGF23, and summarize recent clinical and experimental studies on the pathophysiological roles of endocrine FGFs, mainly FGF23, in CKD patients.

Expert opinion

Among the endocrine FGFs, FGF23 represents the most promising biomarker in CKD patients. If future studies confirm that FGF23 is directly toxic in CKD patients, FGF23 could be regarded as a therapeutic target and its measurement would be valuable if applied in clinical practice. Despite their potentially important roles, the clinical relevance of FGF19 and FGF21 in CKD patients is unclear, and much more studies are required.

中文翻译：

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内分泌成纤维细胞生长因子作为慢性肾病的潜在生物标志物。

介绍

在成纤维细胞生长因子 (FGF) 家族中，FGF19、FGF21 和 FGF23 作为循环激素，被称为内分泌 FGF。FGF19 和 FGF21 分别调节胆汁酸和能量稳态，而 FGF23 调节维生素 D 和磷酸盐稳态。越来越多的证据表明，FGF23 在慢性肾病 (CKD) 患者的矿物质代谢紊乱、左心室肥大、免疫抑制、炎症等方面起着关键作用，突出了作为生物标志物和治疗靶点的潜力。几项研究还检查了 FGF19 和 FGF21 在 CKD 患者中的潜在作用。

覆盖区域

在这篇综述中，我们简要概述了 FGF19、FGF21 和 FGF23 的生物学，并总结了最近关于内分泌 FGF（主要是 FGF23）在 CKD 患者中的病理生理作用的临床和实验研究。

专家意见

在内分泌 FGF 中，FGF23 是 CKD 患者中最有希望的生物标志物。如果未来的研究证实 FGF23 对 CKD 患者具有直接毒性，则 FGF23 可被视为治疗靶点，如果应用于临床实践，其测量将具有价值。尽管它们具有潜在的重要作用，但 FGF19 和 FGF21 在 CKD 患者中的临床相关性尚不清楚，需要更多的研究。