A Biochemical Study of Fibroblast Growth Factor -23 and Phosphorus Metabolism in Adult Patients with Obstructive Renal Failure in Babylon-Iraq

Complete or partial obstruction to the urine's flow can cause gradual and cumulative kidney damage, and this is what is known as obstructive uropathy (OU). The obstruction could be caused by a problem with one or both ureters, and it could occur close to or far from the bladder neck (such as in the urethra). Multiple research have sought to understand the origins and implications of obstructive uropathy, which is a primary cause of renal failure. Fibroblast growth factor23 (FGF23) Osteocytes and osteoblasts create this phosphaturic hormone, which binds to FGF receptors via the transmembrane protein Klotho. Specifically, FGF23 inhibits sodium/phosphate cotransporters NaPi2a and NaPi2c, which in turn inhibits renal phosphate reabsorption, by targeting the renal proximal tubule and decreasing calcitriol synthesis. FGF23 also inhibits the synthesis and secretion of parathyroid hormones by the parathyroid glands. Calcitriol, phosphate, and parathyroid hormone are all involved in the control of FGF23 at the cellular and molecular levels. More FGF23 is found in rare hereditary and acquired illnesses, but chronic kidney disease is also linked to an increase in FGF23 as a reaction to Hyperphosphatemia. However, Increased levels of FGF23 have been associated to deterioration of chronic kidney disease. Whether FGF23 is linked to renal impairment and an increased risk of death .The study's objective was to take measurements of serum level of Fibroblast growth factor- 23 (FGF-23) and phosphorus in people suffering from obstructive renal failure and healthy control subject and to assess the relation of each of them. The study involved collecting blood samples from 100 volunteers, 50 healthy subjects (38 men and 12 women), (34 men and 16 women) suffering from obstructive renal failure.age was (15 –65) years BMI with (18.5-24.9) Kg m-2. Patients were subjected to Kidney Surgery Department at Hillah Hospital from The period from1st of December, 2020 to 1 of June, 2021. The findings revealed statistically significant variations (P<0.0001) in the serum FGF23 level between obstructive renal failure group (501.3±230.89 Pg ml-1) compared with control group (119.63±29.8 Pg ml-1). P = <0.001 for Phosphorus obstructive renal failure group (2.01±0.76 mmol L-1) compared with control group (0.68±0.39 mmol L-1).The results of levels of Hemoglobin& GFR in the of people with obstructive renal disease were significantly lower than healthy people and significantly, as the value of P <0.05. The level of occurrence of The Fibroblast growth factore23 & phosphors is higher in patient with obstructive renal failure than those healthy control, The FGF23 could be served as a diagnostic marker in obstructive renal failure patients to predict the possibility to develop chronic kidney disease, The occurrence of obstructive renal disease at a large rate in old age and in men more than women.