FGF23

Chr 12

fibroblast growth factor 23

Also known as: ADHR, FGFN, HFTC2, HPDR2, HYPF, PHPTC

This gene encodes a member of the fibroblast growth factor family of proteins, which possess broad mitogenic and cell survival activities and are involved in a variety of biological processes. The product of this gene regulates phosphate homeostasis and transport in the kidney. The full-length, functional protein may be deactivated via cleavage into N-terminal and C-terminal chains. Mutation of this cleavage site causes autosomal dominant hypophosphatemic rickets (ADHR). Mutations in this gene are also associated with hyperphosphatemic familial tumoral calcinosis (HFTC). [provided by RefSeq, Feb 2013]

GeneReviewsResearchGenerating clinical summary…

Primary Disease Associations & Inheritance

UniProtHypophosphatemic rickets, autosomal dominant
UniProtTumoral calcinosis, hyperphosphatemic, familial, 2
9
Active trials
493
Pubs (1 yr)
P/LP submissions
P/LP missense
1.28
LOEUF
Multiple*
Mechanism· predicted
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GeneReview available — FGF23
Authoritative clinical overview · Recommended first read
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Some data sources returned errors (1)

omim: Error: OMIM fetch failed: 429

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint?
1.28LOEUF
pLI 0.031
Z-score 1.14
OE 0.50 (0.231.28)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint?
0.40Z-score
OE missense 0.91 (0.801.04)
150 obs / 164.3 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios?
LoF OE?0.50 (0.231.28)
00.351.4
Missense OE?0.91 (0.801.04)
00.61.4
Synonymous OE?0.78
01.21.6
LoF obs/exp: 3 / 6.0Missense obs/exp: 150 / 164.3Syn Z: 1.49

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

FGF23 · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Ischemic Heart DiseaseChronic Coronary SyndromeOptical Coherence Tomography (OCT)

Evaluating the Role of IGF-1 and S-Klotho In Plaque Phenotype and Vulnerability: the VISION Study.

ACTIVE NOT RECRUITING
NCT06522074Fondazione Policlinico Universitario Agostino Gemelli IRCCSStarted 2024-10-15
Coronary angiography with OCT
Kidney Disease, ChronicKidney Failure Chronic

Physical Exercise and Biomolecular Analysis to Reduce Uremic Toxins in Chronic Kidney Disease: An Exploratory Study

ENROLLING BY INVITATION
NCT06910475Phase NACatholic University of BrasíliaStarted 2025-04-01
Resistance trainingEndurance trainingConcurrent training
Phosphate DiabetesX-linked Hypophosphatemia

Phosphorus-31 Spectroscopy in Phosphate Diabetes

RECRUITING
NCT06921720Phase NAHospices Civils de LyonStarted 2025-05-16
intra-muscular ATP values in phosphate diabetesintra-muscular phosphate values in phosphate diabetes
Acute Coronary Syndromes (ACS)Iron DeficienciesElderly (People Aged 65 or More)

Effect of Intravenous Iron on Quality of Life in Older Patients With Acute Coronary Syndrome

RECRUITING
NCT07476859Phase PHASE4Fundación para la Investigación del Hospital Clínico de ValenciaStarted 2026-03-05
Ferric Carboxymaltose Injection [Ferinject]
Obesity, Morbid

Different Limb Lengths in Gastric Bypass Surgery (SLIM) - Part 3: Metabolism and Inflammation

ACTIVE NOT RECRUITING
NCT05471037Phase NAUniversity Hospital, Basel, SwitzerlandStarted 2022-08-01
Long Biliopancreatic Limb LRYGBShort Biliopancreatic Limb LRYGB
Heart Failure

Acute Reno-Cardiac Action of Dapagliflozin In Advanced Heart Failure Patients on Heart Transplant Waiting List

RECRUITING
NCT06868797Phase NACentral Hospital, Nancy, FranceStarted 2025-08-29
Biological sample for the measurement of suPAR levels.
Periodontal DiseasesAcute Coronary Artery Disease

Klotho Gene, Red Complex Bacteria and Periodontal Viruses in Patients With and Without Periodontitis and Acute Coronary Syndrome

NOT YET RECRUITING
NCT07504744Meenakshi Ammal Dental College and HospitalStarted 2026-08-05
FGFR2 Gene Fusion/RearrangementOther Solid Tumors, Adult

A Study of Lirafugratinib in Non-CCA Solid Tumors With FGFR2 Fusion or Rearrangement

RECRUITING
NCT07359820Phase PHASE2Elevar TherapeuticsStarted 2026-06-04
Lirafugratinib
Healthy Adults

Safety and Efficacy of Injectable Klotho Plasmid Gene Therapy in Humans

ACTIVE NOT RECRUITING
NCT07216781Phase PHASE1MinicircleStarted 2025-10-06
Injectable Plasmid Klotho Gene Therapy