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JCI online early table of contents: Oct. 10, 2011

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NEPHROLOGY: Mechanistic link to increased risk of death in chronic kidney disease

It is estimated that approximately 26 million people in the United States have chronic kidney disease (CKD). These people are at increased risk of death from cardiovascular disease (a group of diseases of the heart or blood vessels that includes those that cause heart attack and stroke). Enlargement of the muscle wall of the main chamber of the heart (a condition known as left ventricular hypertrophy [LVH]) is a key factor in the development of cardiovascular disease in individuals with CKD. A team of researchers led by Myles Wolf and Christian Faul, at the University of Miami Miller School of Medicine, Miami, has now identified a potential approach to slowing the progression of LVH in individuals with CKD.

The initial analysis of Wolf, Faul, and colleagues determined that in a large, racially diverse group of individuals with CKD, elevated levels of the protein FGF23 are associated with LVH. These data confirm previous studies. However, Wolf, Faul, and colleagues went on to show that FGF23 has a causal role in LVH in rodents and that in a mouse model of CKD, LVH can be attenuated by administration of a molecule that blocks the protein to which FGF23 binds to mediate its effects. They therefore suggest that blocking the actions of FGF23 could perhaps reduce LVH and cardiovascular events in patients with CKD and thereby improve their survival.

TITLE: FGF23 induces left ventricular hypertrophy

Myles Wolf
University of Miami Miller School of Medicine, Miami, Florida, USA.
Phone: 305.243.7760; Fax: 305.243.8914; E-mail:

Christian Faul

Contact: Karen Honey
Journal of Clinical Investigation

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