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Fibroblast growth factor 23 is coded by the gene FGF23 at 12p13.32. It acts as a hormone that lowers plasma phosphate level due to inhibition of renal tubule phosphate reabsorption. There is increased FGF-23 synthesis in patients with chronic kidney disease which maintains phosphate concentration. Defects in the gene cause autosomal dominant hypophosphatemic rickets and hyperphosphatemic familial tumoral calcinosis. The 251 amino acid peptide is cleaved to:
  • Fibroblast growth factor 23 N-terminal peptide
  • Fibroblast growth factor 23 C-terminal peptide

Excessive expression leads to impaired spatial learning and memory.

There are rare bone tumours that secreted FGF23 known as phosphaturic mesenchymal tumour.[1] It may present with osteomalacia that does not respond to vitamin D.


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