Table 1. Pre-clinical and clinical data of circulating FGF23 in acute kidney injury.
| Authors (year) | Research subjects | Etiology | Diagnosis | Renal function | FGF23 assay | Potential clinical implication | |||
|---|---|---|---|---|---|---|---|---|---|
| Sample type | Intact ELISA | C-terminal ELISA | Predict AKI | Predict outcomes | |||||
| Zhang et al. (2011)30 | 12 AKI vs. 8 controls in ICU | ATN, CRS, OLT, other | AKIN ≥stage I | 3.2-fold ↑ peak SCr from baseline in AKI vs controls | Plasma (closest to peak SCr for AKI cases) | (1) 7.7-fold ↑ FGF23 in AKI vs controls; (2) 8.2-fold ↑ FGF23 in AKI non survivors vs AKI survivors | N/A | Yes, ↑ for mortality | |
| Leaf, et al. (2012)31 | 30 AKI vs. 30 controls | ATN, sepsis, nephrotoxin, HRS, AIN, Rhab | AKIN ≥stage I | Plasma (within 24h of AKI for cases) | 5.6-fold ↑ FGF23 in AKI vs controls | N/A | Yes, ↑ for mortality and RRT | ||
| Leaf, et al. (2013)32 | 30 AKI vs. 30 controls | Same cohort as above | AKIN ≥stage I | Plasma | Same cohort as above | N/A | Yes, ↑ for severe sepsis | ||
| Ali et al. (2013)33 | 5 AKI vs. 14 non-AKI children after surgery | CPB | pRIFLE injury or higher | 1.9-fold ↑ peak SCr in AKI vs non-AKI | Plasma | (1) 4.7-fold ↑ pre-op FGF23 in AKI vs non-AKI; (2) 5.2-fold ↑ in peak post-op FGF23 in AKI vs non-AKI |
Yes | ||
| Christov et al. (2013)34 | 4 AKI vs. 10 controls after cardiac surgery | CABG, valve, other | SCr≥50% within 5 days after surgery | 1.5-fold ↑ SCr at 24h in AKI vs controls | Plasma | 15.9-fold ↑ FGF23 in AKI vs controls at 24h | Yes, ↑ earlier than SCr | N/A | |
| Brown et al. (2014)35 | 3241 elders from CHS cohort | ICD-9-CM: 584, 584.5-584.9 | Plasma | 2-fold ↑ FGF23 independently associated with a higher risk of AKI hospitalizations | N/A | Yes, ↑ for AKI hospitalizations | |||
| Christov et al (2013)34 | Murine model | Folic acid | 5 fold ↑ BUN at 24h | Plasma | First ↑ at 2h; 19-fold ↑ at 24h post-AKI | First ↑ at 1h; 17-fold ↑ at 24h after AKI | Yes, ↑ earlier than NGA | N/A | |
AIN: acute interstitial nephritis; AKIN: acute kidney injury network; ATN: acute tubular necrosis; CABG: coronary artery bypass; CPB: cardiopulmonary bypass; CRS: cardiorenal syndrome; cFGF23: C-terminal FGF23 measured by C-terminal FGF23 kit; CHS: cardiovascular health study; HRS: hepatorenal syndrome; ICD-9-CM: international classification of disease, ninth revision, clinical modification diagnosis codes; iFGF23: intact FGF23; N/A: no available information; NGAL: neutrophil gelatinase-associated lipocalin; OLT: orthotopic liver transplantation; pre-op: pre-operative; pRIFLE: pediatric-modified RIFLE (Risk, Injury, and Failure; and Loss; and End-stage kidney disease); post-op: post-operative; Rhabd: rhabdomyolysis; RRT: renal replacement therapy; SCr: serum creatinine