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Cardiovascular Calcification in Chronic Kidney Disease—Therapeutic Opportunities
Open AccessReview

Klotho/FGF23 and Wnt Signaling as Important Players in the Comorbidities Associated with Chronic Kidney Disease

Maimonides Institute for Biomedical Research (IMIBIC), 14005 Cordoba, Spain
School of Medicine, Department of Medicine, University of Cordoba, 14005 Cordoba, Spain
Nephrology Service, Reina Sofia University Hospital, 14005 Cordoba, Spain
Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, 28029 Madrid, Spain
Author to whom correspondence should be addressed.
These authors share first authorship.
These authors share last authorship.
Toxins 2020, 12(3), 185;
Received: 15 January 2020 / Revised: 5 March 2020 / Accepted: 11 March 2020 / Published: 16 March 2020
(This article belongs to the Special Issue Comorbidities in Chronic Kidney Disease (CKD))
Fibroblast Growth Factor 23 (FGF23) and Klotho play an essential role in the regulation of mineral metabolism, and both are altered as a consequence of renal failure. FGF23 increases to augment phosphaturia, which prevents phosphate accumulation at the early stages of chronic kidney disease (CKD). This effect of FGF23 requires the presence of Klotho in the renal tubules. However, Klotho expression is reduced as soon as renal function is starting to fail to generate a state of FGF23 resistance. Changes in these proteins directly affect to other mineral metabolism parameters; they may affect renal function and can produce damage in other organs such as bone, heart, or vessels. Some of the mechanisms responsible for the changes in FGF23 and Klotho levels are related to modifications in the Wnt signaling. This review examines the link between FGF23/Klotho and Wnt/β-catenin in different organs: kidney, heart, and bone. Activation of the canonical Wnt signaling produces changes in FGF23 and Klotho and vice versa; therefore, this pathway emerges as a potential therapeutic target that may help to prevent CKD-associated complications. View Full-Text
Keywords: FGFG23; Klotho; Wnt/β-catenin; CKD; cardiorenal syndrome FGFG23; Klotho; Wnt/β-catenin; CKD; cardiorenal syndrome
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Muñoz-Castañeda, J.R.; Rodelo-Haad, C.; Pendon-Ruiz de Mier, M.V.; Martin-Malo, A.; Santamaria, R.; Rodriguez, M. Klotho/FGF23 and Wnt Signaling as Important Players in the Comorbidities Associated with Chronic Kidney Disease. Toxins 2020, 12, 185.

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