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The bone-derived hormone fibroblast growth factor–23 (FGF-23) activates complexes composed of FGF receptors (FGFRs), including FGFR1, and  α -Klotho in the kidney distal tubule (DT), leading to increased sodium retention and hypertension. However, the role of FGFR1 in regulating renal processes linked to hypertension is unclear. Here, we investigated the effects of selective FGFR1 loss in the DT. Conditional knockout (cKO) of  FGFR1  in the DT ( FGFR1 DT-cKO   mice) resulted in left ventricular hypertrophy (LVH) and decreased kidney expression of  α -Klotho in association with enhanced BP, decreased expression of angiotensin converting enzyme 2, and increased expression of the Na + -K + -2Cl −  cotransporter. Notably, recombinant FGF-23 administration similarly decreased the kidney expression of  α -Klotho and induced LVH in mice. Pharmacologic activation of FGFR1 with a monoclonal anti-FGFR1 antibody (R1MAb1) normalized BP and significantly attenuated LVH in the  Hyp  mouse model of excess FGF-23, but did not induce a response in  FGFR1 DT-cKO   mice. The hearts of  FGFR1 DT-cKO   mice showed increased expression of the transient receptor potential cation channel, subfamily C, member 6 (TRPC6), consistent with cardiac effects of soluble Klotho deficiency. Moreover, administration of recombinant soluble Klotho lowered BP in the  Hyp  mice. Thus, FGFR1 in the DT regulates systemic hemodynamic responses opposite to those predicted by the actions of FGF-23. These cardiovascular effects appear to be mediated by paracrine FGF control of kidney FGFR1 and subsequent regulation of soluble Klotho and TRPC6. FGFR1 in the kidney may provide a new molecular target for treating hypertension.

Cardiovascular Effects of Renal Distal Tubule Deletion of the FGF Receptor 1 Gene