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Background  Chronic kidney disease ( CKD ) is associated with hyperphosphatemia, decreased vitamin D metabolite concentrations, and hyperparathyroidism. This syndrome is known as  CKD ‐mineral bone disorder ( CKD ‐ MBD ). Recently, it has been shown that an increase in fibroblast growth factor‐23 ( FGF ‐23) concentration is an early biomarker of  CKD  in people. It is an independent risk factor for both progression of renal disease and survival time in humans and cats with  CKD . Information about  FGF ‐23 in healthy dogs and those with  CKD  is lacking.    Objectives  To measure  FGF ‐23 concentration in dogs with different stages of  CKD  and determine its association with factors involved in  CKD ‐ MBD , including serum phosphorus and parathyroid hormone ( PTH ) concentrations. A secondary aim was to validate an  ELISA  for measurement of plasma  FGF ‐23 concentration in dogs.    Animals  Thirty‐two client‐owned dogs with naturally occurring  CKD  and 10 healthy control dogs.    Methods  Prospective cross‐sectional study. An  FGF ‐23  ELISA  was used to measure plasma  FGF ‐23 concentration in dogs and their association with serum creatinine, phosphorus, calcium, and  PTH  concentrations.    Results  Plasma  FGF ‐23 concentrations increased with severity of  CKD  and were significantly different between  IRIS  stages 1 and 2 versus stages 3 and 4 ( P  < .0001). Increases in  FGF ‐23 concentrations were more frequent than hyperparathyroidism or hyperphosphatemia in this cohort. Serum creatinine and phosphorus concentrations were the strongest independent predictors of  FGF ‐23 concentration.    Conclusions and clinical importance  Plasma  FGF ‐23 concentrations increase in dogs with  CKD  as disease progresses. Plasma  FGF ‐23 concentrations appear to be useful for further study of the pathophysiology of  CKD ‐ MBD  in dogs.

Fibroblast Growth Factor‐23 Concentration in Dogs with Chronic Kidney Disease