Keeping phosphorus under control to improve the quality of patients with renal failure

October 25, 2018

The FGF23 (Fibroblast growth factor 23) hormone originates in bone to communicate with the kidney whose duty it is to excrete excess phosphorus that the bone detects. Its main function is bone-kidney communication to eliminate phosphorus, but what happens when the person has renal failure and kidneys that do not work in addition to an impaired excretion ability? What happens is that the failing kidney is unable to abide by FGF23. Nevertheless, the bone keeps producing this hormone because it does not detect that the kidney has stopped working, resulting in a build-up of FGF23 in the blood.

The build-up of this hormone causes troublesome effects on other organs. For instance, the cardiovascular system is affected by high levels of this hormone; the heart enlarges (this is known as hypertrophy) and this increases risk of death. This led a research team made up of researchers from the University of Cordoba's Medical School, the GC13 and GC07 groups from the Maimonides Institute of Biomedical Research (the acronym is IMIBIC in Spanish) and the Nephrology Unit at the Queen Sofia University Hospital to focus on how to lower levels of FGF23.

After a clinical trial on 21 patients in dialysis treatment for forty weeks, they were able to prove that by following a diet with low phosphorus intake and taking medication based on phosphate binders, which prevent the body from absorbing it, the group of patients showed a correction of the high levels of phosphorus and produced a considerable decrease of the FGF23 hormone. Therefore, the effort of lowering phosphorus levels would also work to decrease the concentration of FGF23 and reduce the risks of circulation and heart problems.

Call it by its name

Another advance coming out of this research project, headed by researcher Cristian Rodelo Haad and including UCO Medicine Professors Mariano Rodriguez and Alejandro Martin-Malo, is differentiating two parts of the hormone: intact FGF23 (iFGF23) and FGF23 c-terminal (c-FGF23). In this research project, made up of 150 patients, the complete intact hormone was considered and conversely the resulting parts of fragmentation (c-terminal), since the final quantity of these depends on specific factors.

While phosphorus is responsible for more than 60% of the molecule values in both cases, for the intact hormone phosphorus and calcium in the blood are defining, and for the c-terminal the time that the patient has undergone dialysis and inflammation are factors that increase its concentration.

Once proven that with medication and a diet low in phosphorus people who suffer from kidney failure are able to lower the levels of FGF23 in their bodies, future research aims to study how this reduction increases life expectancy in the long term.
-end-
Rodelo-Haad, C; Rodriguez-Ortiz, ME; Martin-Malo, A; de Mier, MVPR; Aguera, ML; Munoz-Castaneda, JR; Soriano, S; Caravaca, F; Alvarez-Lara, MA; Felsenfeld, A; Aljama, P; Rodriguez, M. Phosphate control in reducing FGF23 levels in hemodialysis patients. PLOS ONEhttps://doi.org/10.1371/journal.pone.0201537

University of Córdoba

Related Phosphorus Articles from Brightsurf:

Blue phosphorus: How a semiconductor becomes a metal
Blue phosphorus, an atomically thin synthetic semiconductor, becomes metallic as soon as it is converted into a double layer.

Phosphorus deficit may disrupt regional food supply chains
Phosphorus-based fertilizer is essential in modern agriculture. In regions with high population growth, more phosphorus will be needed to produce more food.

SwRI scientist searches for stellar phosphorus to find potentially habitable exoplanets
SAN ANTONIO -- Sept. 16, 2020 -- A Southwest Research Institute scientist has identified stellar phosphorus as a probable marker in narrowing the search for life in the cosmos.

Worldwide loss of phosphorus due to soil erosion quantified for the first time
Phosphorus is essential for agriculture, yet this important plant nutrient is increasingly being lost from soils around the world.

Stars rich in phosphorus: Seeds of life in the universe
The journal Nature Communications today is publishing the discovery of a new type of stars, very rich in phosphorus, which could help to explain the origin of this chemical element in our Galaxy.

Black phosphorus future in 3D analysis, molecular fingerprinting
Many compact systems using mid-infrared technology continue to face compatibility issues when integrating with conventional electronics.

Fostering a sustainable use of phosphorus
Phosphorus is critical to food security, ecosystem functioning and human activities.

Newly discovered plant gene could boost phosphorus intake
Researchers from the University of Copenhagen have discovered an important gene in plants that could help agricultural crops collaborate better with underground fungi -- providing them with wider root networks and helping them to absorb phosphorus.

Anaerobically disinfect soil to increase phosphorus using diluted ethanol
Anaerobic disinfection of soil is an effective method to kill unwanted bacteria, parasites and weeds without using chemical pesticides.

Graphene heterostructures with black phosphorus, arsenic enable new infrared detectors
MIPT scientists and their colleagues from Japan and the U.S.

Read More: Phosphorus News and Phosphorus Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.