Chronic renal failure and new molecular marters in pediatrics Enfermedad renal crónica en pediatría y nuevos marcadores moleculares

Abstract

Chronic Renal Failure (CRF) is associated in the mid and long-term to severe complications. New therapies have been introduced in the last decades, however some disturbances as growth failure, mineral metabolism, and anemia, among others, still remain unresolved, and long-term cardiovascular morbimortality remains unacceptable high. In recent years, new molecular markers have been introduced as promising tools in the prevention and management of uremic disturbances. Fibroblast Growth Factor23 (FGF23), Klotho, Hepcidin and growth hormone (GH) intracellular signaling are discussed in this article. FGF23, acting through Klotho protein, increases the rate of urinary excretion of phosphate and inhibits renal production of 1,25-dihydroxyvitamin D, as an important regulator of mineral metabolism. Hepcidin inhibits intestinal iron absorption and iron release from macrophages and hepatocytes; its production is increased by inflammation and high hepcidin plasma levels limit iron availability for