Figure 5 Potential roles of phosphate and fibroblast growth factor 23 (FGF-23) in the development of cardiovascular disease in patients with chronic kidney.

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Figure 5 Potential roles of phosphate and fibroblast growth factor 23 (FGF-23) in the development of cardiovascular disease in patients with chronic kidney disease (CKD) Figure 5 | Potential roles of phosphate and fibroblast growth factor 23 (FGF-23) in the development of cardiovascular disease in patients with chronic kidney disease (CKD). Patients with CKD often have hyperphosphataemia and high circulating levels of FGF-23. High levels of FGF-23 might directly induce left ventricular hypertrophy by stimulating pathological hypertrophic gene transcription in cardiomyocytes. In parallel, hyperphosphataemia and klotho deficiency disturb endothelial cell function and augment arterial wall calcification and valvular disease. These two processes might contribute to the high burden of cardiovascular events in CKD. Reproduced with permission from Springer Nature © Scialla, J.J. & M. Wolf. Nat. Rev. Nephrol. 10, 268–278 (2014). Reproduced with permission from Springer Nature © Scialla, J.J. & M. Wolf. Nat. Rev. Nephrol. 10, 268–278 (2014). Vervloet, M. G. et al. (2016) The role of phosphate in kidney disease Nat. Rev. Nephrol. doi:10.1038/nrneph.2016.164