{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:33:24Z","timestamp":1787589204926,"version":"build-2736575974"},"reference-count":31,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) affects 10% of the global population. This meta-analysis evaluated fibroblast growth factor 23 (FGF-23) as a prognostic biomarker for CKD progression, kidney failure, cardiovascular events, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Cochrane, Embase, and SCOPUS from inception through January 2025. Twelve prospective cohort studies enrolling 21,042 pre-dialysis adult patients with CKD stages 1\u20135 were included; outcomes encompassed kidney function decline, progression to kidney failure, cardiovascular events, heart failure, and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Elevated fibroblast growth factor (FGF)-23 levels were associated with lower estimated glomerular filtration rate (eGFR) (mean difference: 17.83 mL\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      ). In mild-moderate CKD, each 10 relative units (RU)\/mL FGF-23 increase conferred 1.7% higher kidney failure risk (hazard ratio (HR) 1.01, 95% confidence interval (CI) [1.01\u20131.02]). In advanced CKD, highest\n                      <jats:italic>vs<\/jats:italic>\n                      . lowest FGF-23 quartile showed 2.32-fold increased kidney failure risk (95% CI [1.80\u20132.98]). High FGF-23 associated with increased cardiovascular events (HR 1.72, 95% CI [1.34\u20132.20]), heart failure (HR 2.14, 95% CI [1.53\u20133.00]), and all-cause mortality (HR 1.61, 95% CI [1.40\u20131.87]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FGF-23 is a significant prognostic biomarker predicting CKD progression, cardiovascular events, and mortality, supporting its utility in risk stratification and personalized management. Incorporating FGF-23 measurement into routine CKD care may enable earlier risk stratification and more targeted clinical interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.21668","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:58:36Z","timestamp":1787587116000},"page":"e21668","source":"Crossref","is-referenced-by-count":0,"title":["Role of fibroblast growth factor 23 in predicting CKD progression and prognosis: a systematic review and meta-analysis"],"prefix":"10.7717","volume":"14","author":[{"given":"Jia-Wei","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Nephrology, Taichung Veterans General Hospital, Taichung City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiang-Ping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nursing, HungKuang University, Taichung City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsay-I","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Nursing, HungKuang University, Taichung City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"issue":"1","key":"10.7717\/peerj.21668\/ref-1","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1186\/s12882-021-02528-2","article-title":"Longitudinal change in c-terminal fibroblast growth factor 23 and outcomes in patients with advanced chronic kidney disease","volume":"22","author":"Alderson","year":"2021","journal-title":"BMC Nephrology"},{"issue":"1","key":"10.7717\/peerj.21668\/ref-2","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1093\/ndt\/gft456","article-title":"Time-averaged level of fibroblast growth factor-23 and clinical events in chronic kidney disease","volume":"29","author":"Bouma-de 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