Higher risk of AF with CKD linked to fibroblast growth factor 23

Higher risk of AF with CKD linked to fibroblast growth factor 23

Fibroblast growth factor 23 and AF (atrial fibrillation): Fibroblast growth factor-23 (FGF-23) is hormone derived from the bone, which rises in chronic kidney disease (CKD) in an attempt to maintain proper phosphate homeostasis. FGF-23 enhances excretion of phosphate in urine and inhibits intestinal absorption of phosphate by reducing the production of 1,25-dihydroxycholecalciferol (1,25-dihydroxyvitamin D3). Analysis of data from The Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS) has shown a link between FG-23 and atrial fibrillation [1]. Higher circulating levels of FGF-23 was associated with new onset of atrial fibrillation. The finding may partly explain the link between chronic kidney disease and atrial fibrillation. The mechanism may be by inducing left ventricular hypertrophy and left atrial dysfunction.

In previous studies, FGF-23 has been linked with cardiovascular disease, heart failure, myocardial infarction and cardiovascular mortality.

Reference

1. Jehu S Mathew, Michael C Sachs, Ronit Katz, Kristen K Patton, Susan R Heckbert, Andrew N Hoofnagle, Alvaro Alonso, Michel Chonchol, Rajat Deo, Joachim H Ix, David S Siscovick, Bryan Kestenbaum, Ian H de Boer. Fibroblast Growth factor-23 and Incident Atrial Fibrillation: The Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS). Circulation. 2014; 130: 298-307.