El papel del factor de crecimiento de fibroblastos 23 (FGF-23) en el trastorno mineral y óseo asociado a la enfermedad renal crónica (TMO-ERC)
The role of Fibroblast Growth Factor 23 in chronic kidney disease-mineral and bone disorder
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Los niveles de FGF-23 se encuentran extremamente elevados en la enfermedad renal crónica y existe evidencia del papel de esta hormona en la patogénesis de los trastornos óseos y minerales en esta situación. Más aún, datos recientes implican al FGF-23 en la patogénesis de otras complicaciones sistémicas asociadas a las alteraciones óseo-minerales de la enfermedad renal crónica. La evidencia creciente de que las alteraciones del metabolismo mineral no se limitan a la enfermedad ósea ha acentuado el interés por la patofisiología y el tratamiento de las alteraciones del metabolismo mineral en la enfermedad renal crónica. Se ha propuesto que el aumento de FGF-23 es la respuesta inicial en los estadios precoces de la enfermedad renal crónica a la necesidad de proteger al organismo de los efectos adversos de la retención de fósforo. Estos aumentos de FGF-23 se asocian al riesgo creciente de mortalidad cardiovascular en los enfermos renales crónicos y son mediadores directos de toxicidad cardíaca. En esta revisión procuramos presentar aspectos relevantes de la fisiología del FGF-23 en la biología ósea y en la homeostasis mineral, así como en la fisiopatología de la enfermedad renal crónica y sus implicaciones clínicas.</p>" ] "en" => array:1 [ "resumen" => "<p class="elsevierStylePara">Fibroblast Growth Factor 23 (FGF-23) is a bone-derived hormone involved in the regulation of phosphate homeostasis. FGF-23 levels are extremely elevated in Chronic Kidney Disease (CKD) and there is evidence supporting the role of this hormone in the pathogenesis of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Furthermore, recent data associates FGF-23 with the pathogenesis of systemic complications of CKD-MBD. The increasing evidence that the consequences of abnormal mineral metabolism are not restricted to bone disease changed the approach to the pathophysiology and treatment of disturbed bone and mineral metabolism in CKD patients. FGF-23 has been proposed to be the initial adaptive response in early CKD to protect the organism from the adverse effects of phosphate retention. Increased levels of FGF-23 observed in CKD patients are associated with cardiovascular mortality risk and was shown to mediate direct, "off-target" toxicity to the heart. This report aims to review the relevant aspects of the physiology of FGF-23 in bone biology and mineral homeostasis and the role of FGF-23 in the pathophysiology of CKD-BMD and its clinical implications.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:94 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Wolf M. Update on fibroblast growth factor 23 in chronic kidney disease. Kidney Int 2012;82(7):737-47. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22622492" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Fukagawa M, Akizawa T. Calcium abnormalities of dialysis patients. 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| 2022 Enero | 48 | 39 | 87 |
| 2021 Diciembre | 45 | 53 | 98 |
| 2021 Noviembre | 46 | 44 | 90 |
| 2021 Octubre | 41 | 52 | 93 |
| 2021 Septiembre | 42 | 64 | 106 |
| 2021 Agosto | 34 | 59 | 93 |
| 2021 Julio | 32 | 36 | 68 |
| 2021 Junio | 41 | 36 | 77 |
| 2021 Mayo | 59 | 48 | 107 |
| 2021 Abril | 122 | 87 | 209 |
| 2021 Marzo | 77 | 38 | 115 |
| 2021 Febrero | 55 | 26 | 81 |
| 2021 Enero | 47 | 32 | 79 |
| 2020 Diciembre | 40 | 21 | 61 |
| 2020 Noviembre | 31 | 15 | 46 |
| 2020 Octubre | 33 | 30 | 63 |
| 2020 Septiembre | 33 | 15 | 48 |
| 2020 Agosto | 41 | 28 | 69 |
| 2020 Julio | 57 | 24 | 81 |
| 2020 Junio | 41 | 34 | 75 |
| 2020 Mayo | 88 | 16 | 104 |
| 2020 Abril | 92 | 43 | 135 |
| 2020 Marzo | 44 | 29 | 73 |
| 2020 Febrero | 67 | 35 | 102 |
| 2020 Enero | 82 | 31 | 113 |
| 2019 Diciembre | 63 | 37 | 100 |
| 2019 Noviembre | 71 | 41 | 112 |
| 2019 Octubre | 30 | 16 | 46 |
| 2019 Septiembre | 58 | 44 | 102 |
| 2019 Agosto | 53 | 25 | 78 |
| 2019 Julio | 95 | 28 | 123 |
| 2019 Junio | 159 | 51 | 210 |
| 2019 Mayo | 62 | 28 | 90 |
| 2019 Abril | 132 | 44 | 176 |
| 2019 Marzo | 107 | 41 | 148 |
| 2019 Febrero | 97 | 31 | 128 |
| 2019 Enero | 77 | 43 | 120 |
| 2018 Diciembre | 190 | 50 | 240 |
| 2018 Noviembre | 199 | 39 | 238 |
| 2018 Octubre | 164 | 27 | 191 |
| 2018 Septiembre | 150 | 19 | 169 |
| 2018 Agosto | 118 | 25 | 143 |
| 2018 Julio | 91 | 17 | 108 |
| 2018 Junio | 105 | 29 | 134 |
| 2018 Mayo | 129 | 25 | 154 |
| 2018 Abril | 125 | 17 | 142 |
| 2018 Marzo | 97 | 22 | 119 |
| 2018 Febrero | 87 | 13 | 100 |
| 2018 Enero | 152 | 16 | 168 |
| 2017 Diciembre | 118 | 17 | 135 |
| 2017 Noviembre | 90 | 16 | 106 |
| 2017 Octubre | 86 | 18 | 104 |
| 2017 Septiembre | 80 | 16 | 96 |
| 2017 Agosto | 81 | 24 | 105 |
| 2017 Julio | 91 | 24 | 115 |
| 2017 Junio | 2988 | 19 | 3007 |
| 2017 Mayo | 95 | 18 | 113 |
| 2017 Abril | 97 | 20 | 117 |
| 2017 Marzo | 62 | 27 | 89 |
| 2017 Febrero | 142 | 15 | 157 |
| 2017 Enero | 66 | 13 | 79 |
| 2016 Diciembre | 126 | 12 | 138 |
| 2016 Noviembre | 147 | 21 | 168 |
| 2016 Octubre | 164 | 21 | 185 |
| 2016 Septiembre | 223 | 18 | 241 |
| 2016 Agosto | 343 | 13 | 356 |
| 2016 Julio | 270 | 19 | 289 |
| 2016 Junio | 187 | 0 | 187 |
| 2016 Mayo | 187 | 0 | 187 |
| 2016 Abril | 177 | 0 | 177 |
| 2016 Marzo | 183 | 0 | 183 |
| 2016 Febrero | 173 | 0 | 173 |
| 2016 Enero | 149 | 0 | 149 |
| 2015 Diciembre | 175 | 0 | 175 |
| 2015 Noviembre | 175 | 0 | 175 |
| 2015 Octubre | 192 | 0 | 192 |
| 2015 Septiembre | 156 | 0 | 156 |
| 2015 Agosto | 156 | 0 | 156 |
| 2015 Julio | 160 | 0 | 160 |
| 2015 Junio | 112 | 0 | 112 |
| 2015 Mayo | 215 | 0 | 215 |
| 2015 Abril | 46 | 0 | 46 |
| 2015 Febrero | 2327 | 0 | 2327 |
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