Klotho-FGF23, Cardiovascular Disease, and Vascular Calcification: Black or White?
Giuseppe Cianciolo, Andrea Galassi, Irene Capelli, Roberto Schillaci, Gaetano La Manna, Mario Cozzolino
Author Information
Giuseppe Cianciolo: Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
Andrea Galassi: Department of Health Sciences, Renal Unit, San Paolo Hospital Milan, University of Milan, Milan, Italy.
Irene Capelli: Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
Roberto Schillaci: Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
Gaetano La Manna: Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
Mario Cozzolino: Department of Health Sciences, Renal Unit, San Paolo Hospital Milan, University of Milan, Milan, Italy.
BACKGROUND: Patients affected by Chronic Kidney Disease and Mineral Bone Disorder (CKD-MBD) have a high risk of cardiovascular (CV) mortality that is poorly explained by traditional risk factors. The newest medical treatments for CKD-MBD have been associated with encouraging, but still inconsistent, improvement in CV disease complications and patient survival. A better understanding of the biomarkers and mechanisms of left ventricular hypertrophy (LVH), atherosclerosis, and vascular calcification (VC) may help with diagnosis and treatment of the organ damage that occurs secondary to CKD-MBD, thus improving survival. Recent insights about fibroblast growth factor-23 (FGF23) and its co-receptor, Klotho, have led to marked advancement in interpreting data on vascular aging and CKDMBD. CONCLUSION: This review will discuss the current experimental and clinical evidence regarding FGF23 and Klotho, with a particular focus on their roles in LVH, atherosclerosis, and VC.
