{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:49:52Z","timestamp":1786373392659,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,10]]},"abstract":"Summary<\/jats:title>\n \n Background and objectives<\/jats:title>\n Plasma phosphate levels display considerable intraindividual variability. The phosphatonin fibroblast growth factor 23 is a central regulator of plasma phosphate levels, and it has been postulated to be a more stable marker than conventional CKD\u2013mineral and bone disorder parameters. Thus, fibroblast growth factor 23 has been hypothesized to reflect time-averaged plasma phosphate levels in CKD patients.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n Among 40 patients from the outpatient dialysis center, serial measurements of plasma calcium and phosphate (before every dialysis session) as well as C-terminal fibroblast growth factor 23, parathyroid hormone, and alkaline phosphatase (one time weekly) were performed over a study period of 4 weeks in November and December of 2011. Intraindividual variability of repeated plasma fibroblast growth factor 23 measurements compared with other CKD\u2013mineral and bone disorder markers was tested, and the association of a single plasma fibroblast growth factor 23 measurement with time-averaged plasma phosphate levels was analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Against expectations, intraindividual variability of fibroblast growth factor 23 (median coefficient of variation=27%; interquartile range=20\u201335) was not lower than variability of plasma phosphate (median coefficient of variation=15%; interquartile range=10\u201320), parathyroid hormone (median coefficient of variation=24%; interquartile range=15\u201339), plasma calcium (median coefficient of variation=3%; interquartile range=2\u20134), or alkaline phosphatase (median coefficient of variation=5%; interquartile range=3\u201310). Moreover, the correlation between the last fibroblast growth factor 23 measurement after 4 weeks and time-averaged plasma phosphate did not surpass the correlation between the last fibroblast growth factor 23 measurement and a single plasma phosphate value (\n r<\/jats:italic>\n =0.67,\n P<\/jats:italic>\n <0.001;\n r<\/jats:italic>\n =0.76,\n P<\/jats:italic>\n <0.001, respectively).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Surprisingly, fibroblast growth factor 23 was not more closely associated to time-averaged plasma phosphate levels than a single plasma phosphate value, and it did not show a lower intraindividual variability than other tested markers of CKD\u2013mineral and bone disorder. Thus, fibroblast growth factor 23 should not be used in clinical practice as a reflector of time-averaged plasma phosphate levels.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.13021212","type":"journal-article","created":{"date-parts":[[2013,7,12]],"date-time":"2013-07-12T00:24:22Z","timestamp":1373588662000},"page":"1764-1772","source":"Crossref","is-referenced-by-count":14,"title":["Single FGF-23 Measurement and Time-Averaged Plasma Phosphate Levels in Hemodialysis Patients"],"prefix":"10.2215","volume":"8","author":[{"given":"Sarah","family":"Seiler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Lucisano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Ege","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa H.","family":"Fell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyrill S.","family":"Rogacev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Lerner-Gr\u00e4ber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Klingele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Ziegler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Fliser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar H.","family":"Heine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-19-20230811","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1093\/eurheartj\/ehs247","article-title":"Phosphate: A novel cardiovascular risk factor.","volume":"34","author":"Ketteler","year":"2013","journal-title":"Eur Heart J"},{"key":"R2-19-20230811","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1053\/ajkd.1998.v31.pm9531176","article-title":"Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: A national study.","volume":"31","author":"Block","year":"1998","journal-title":"Am J Kidney Dis"},{"key":"R3-19-20230811","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1097\/01.ASN.0000133041.27682.A2","article-title":"Mineral metabolism, mortality, and morbidity in maintenance hemodialysis.","volume":"15","author":"Block","year":"2004","journal-title":"J Am Soc Nephrol"},{"key":"R4-19-20230811","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1053\/j.ajkd.2008.03.020","article-title":"Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS).","volume":"52","author":"Tentori","year":"2008","journal-title":"Am J Kidney Dis"},{"key":"R5-19-20230811","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1053\/j.ajkd.2008.05.020","article-title":"Disordered mineral metabolism in hemodialysis patients: An analysis of cumulative effects in the Hemodialysis (HEMO) Study.","volume":"52","author":"Wald","year":"2008","journal-title":"Am J Kidney Dis"},{"key":"R6-19-20230811","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1681\/ASN.2011121191","article-title":"Mechanistic insights into vascular calcification in CKD.","volume":"24","author":"Shroff","year":"2013","journal-title":"J Am Soc Nephrol"},{"key":"R8-19-20230811","first-page":"59","article-title":"Ultradian variation in serum phosphate concentration in patients on haemodialysis.","volume":"10","author":"Ring","year":"1995","journal-title":"Nephrol Dial Transplant"},{"key":"R9-19-20230811","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/j.1542-4758.2009.00393.x","article-title":"Variability in calcium, phosphorus, and parathyroid hormone in patients on hemodialysis.","volume":"13","author":"Levitt","year":"2009","journal-title":"Hemodial Int"},{"key":"R10-19-20230811","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1681\/ASN.2005111185","article-title":"Fibroblast growth factor 23 is a counter-regulatory phosphaturic hormone for vitamin D.","volume":"17","author":"Liu","year":"2006","journal-title":"J Am Soc Nephrol"},{"key":"R11-19-20230811","doi-asserted-by":"crossref","first-page":"2683","DOI":"10.1681\/ASN.2006070783","article-title":"Parathyroid hormone regulates fibroblast growth factor-23 in a mouse model of primary hyperparathyroidism.","volume":"18","author":"Kawata","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"R12-19-20230811","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1111\/j.1523-1755.2005.00506.x","article-title":"Effect of fibroblast growth factor-23 on phosphate transport in proximal tubules.","volume":"68","author":"Baum","year":"2005","journal-title":"Kidney Int"},{"key":"R13-19-20230811","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1038\/ki.2009.405","article-title":"Clincial relevance of FGF-23 in chronic kidney disease.","volume":"114","author":"Seiler","year":"2009","journal-title":"Kidney Int Suppl"},{"key":"R14-19-20230811","doi-asserted-by":"crossref","first-page":"3072","DOI":"10.1093\/ndt\/gfs259","article-title":"FGF-23: The rise of a novel cardiovascular risk marker in CKD.","volume":"27","author":"Heine","year":"2012","journal-title":"Nephrol Dial Transplant"},{"key":"R15-19-20230811","doi-asserted-by":"crossref","first-page":"640","DOI":"10.7326\/0003-4819-152-10-201005180-00004","article-title":"The associations of fibroblast growth factor 23 and uncarboxylated matrix Gla protein with mortality in coronary artery disease: The Heart and Soul Study.","volume":"152","author":"Parker","year":"2010","journal-title":"Ann Intern Med"},{"key":"R16-19-20230811","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1093\/eurheartj\/ehq371","article-title":"CD14++CD16+ monocytes and cardiovascular outcome in patients with chronic kidney disease.","volume":"32","author":"Rogacev","year":"2011","journal-title":"Eur Heart J"},{"key":"R17-19-20230811","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1016\/j.jacc.2012.07.019","article-title":"CD14++CD16+ monocytes independently predict cardiovascular events: A cohort study of 951 patients referred for elective coronary angiography.","volume":"60","author":"Rogacev","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"R18-19-20230811","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1093\/ndt\/gfr344","article-title":"Phosphate and FGF23 in early CKD: On how to tackle an invisible foe.","volume":"26","author":"Ketteler","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"R19-19-20230811","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/BF02556839","article-title":"Diurnal variation of serum calcium and phosphorus in postmenopausal women.","volume":"38","author":"Perry","year":"1986","journal-title":"Calcif Tissue Int"},{"key":"R20-19-20230811","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1080\/00365518309169087","article-title":"The circadian rhythms of blood ionized calcium in humans.","volume":"165","author":"Ishida","year":"1983","journal-title":"Scand J Clin Lab Invest Suppl"},{"key":"R21-19-20230811","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.2215\/CJN.04290511","article-title":"Fibroblast growth factor 23 in patients undergoing peritoneal dialysis.","volume":"6","author":"Isakova","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"R22-19-20230811","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.ahj.2011.02.012","article-title":"Plasma fibroblast growth factor 23, parathyroid hormone, phosphorus, and risk of coronary heart disease.","volume":"161","author":"Taylor","year":"2011","journal-title":"Am Heart J"},{"key":"R23-19-20230811","doi-asserted-by":"crossref","first-page":"85","DOI":"10.2215\/CJN.08070811","article-title":"Serum fibroblast growth factor-23 and risk of incident chronic kidney disease in older community-dwelling women.","volume":"7","author":"Semba","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"R24-19-20230811","doi-asserted-by":"crossref","first-page":"3983","DOI":"10.1093\/ndt\/gfq309","article-title":"FGF-23 and future cardiovascular events in patients with chronic kidney disease before initiation of dialysis treatment.","volume":"25","author":"Seiler","year":"2010","journal-title":"Nephrol Dial Transplant"},{"key":"R25-19-20230811","doi-asserted-by":"crossref","first-page":"2432","DOI":"10.1001\/jama.2011.826","article-title":"Fibroblast growth factor 23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease.","volume":"305","author":"Isakova","year":"2011","journal-title":"JAMA"},{"key":"R26-19-20230811","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1681\/ASN.2010121224","article-title":"FGF-23 associates with death, cardiovascular events, and initiation of chronic dialysis.","volume":"22","author":"Kendrick","year":"2011","journal-title":"J Am Soc Nephrol"},{"key":"R27-19-20230811","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1056\/NEJMoa0706130","article-title":"Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis.","volume":"359","author":"Guti\u00e9rrez","year":"2008","journal-title":"N Engl J Med"},{"key":"R28-19-20230811","doi-asserted-by":"crossref","first-page":"2792","DOI":"10.1093\/ndt\/gfp191","article-title":"High levels of serum fibroblast growth factor (FGF)-23 are associated with increased mortality in long haemodialysis patients.","volume":"24","author":"Jean","year":"2009","journal-title":"Nephrol Dial Transplant"},{"key":"R30-19-20230811","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/j.1744-9987.2011.01037.x","article-title":"Low molecular weight iron dextran increases fibroblast growth factor-23 concentration, together with parathyroid hormone decrease in hemodialyzed patients.","volume":"16","author":"Hryszko","year":"2012","journal-title":"Ther Apher Dial"},{"key":"R31-19-20230811","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.2215\/CJN.13281211","article-title":"Fibroblast growth factor 23 and inflammation in CKD.","volume":"7","author":"Munoz Mendoza","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"R32-19-20230811","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1093\/eurheartj\/ehr215","article-title":"The phosphatonin fibroblast growth factor 23 links calcium-phosphate metabolism with left-ventricular dysfunction and atrial fibrillation.","volume":"32","author":"Seiler","year":"2011","journal-title":"Eur Heart J"},{"key":"R33-19-20230811","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1038\/ki.2012.176","article-title":"Update on fibroblast growth factor 23 in chronic kidney disease.","volume":"82","author":"Wolf","year":"2012","journal-title":"Kidney Int"},{"key":"R34-19-20230811","first-page":"144","article-title":"Evaluation of human fibroblast growth factor 23 (FGF-23) C-terminal and intact enzyme-linked immunosorbent-assays in end-stage renal disease patients.","volume":"55","author":"Fassbender","year":"2009","journal-title":"Clin Lab"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01277230-201310000-00019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:45:31Z","timestamp":1786369531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01277230-201310000-00019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2013]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.13021212","relation":{},"ISSN":["1555-9041"],"issn-type":[{"value":"1555-9041","type":"print"}],"subject":[],"published":{"date-parts":[[2013,10]]}}}