Fibroblast Growth Factor 23 and αKlotho in Acute Kidney Injury: Current Status in Diagnostic and Therapeutic Applications

Nephron. 2020;144(12):665-672. doi: 10.1159/000509856. Epub 2020 Aug 25.


Fibroblast growth factor (FGF) 23 and αKlotho are circulating mineral regulatory substances that also have a very diverse range of actions. Acute kidney injury (AKI) is a state of high FGF23 and low αKlotho. Clinical association data for FGF23 are strong, but the basic pathobiology of FGF23 in AKI is rather sparse. Conversely, preclinical data supporting a pathogenic role of αKlotho in AKI are strong, but the human data are still being generated. This pair of substances can potentially serve as diagnostic and prognostic biomarkers. FGF23 blockade and αKlotho restoration can have prophylactic and therapeutic utility in AKI. The literature to date is briefly reviewed in this article.

Keywords: Acute kidney injury; Biomarker; Chronic kidney disease; FGF23; Treatment; αKlotho.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / physiopathology*
  • Acute Kidney Injury / therapy
  • Animals
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / physiology*
  • Glucuronidase / physiology*
  • Humans
  • Klotho Proteins
  • Prognosis


  • FGF23 protein, human
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23
  • Glucuronidase
  • Klotho Proteins