
This prospective cohort study examines the role of fibroblast growth factor (FGF) 23 in predicting diabetic kidney disease (DKD) over 4.6 years. Among 1614 individuals with diabetes, baseline FGF23 levels were found to rise early in DKD progression, correlating with disease severity. Elevated FGF23 levels were significantly associated with DKD incidence (OR 1.290 [95% CI 1.063, 1.565]), particularly in individuals with lower BMI, poor glycemic control (HbA1c ≥7%), and shorter diabetes duration. Incorporating FGF23 into DKD risk models enhanced predictive performance, highlighting its potential for early detection and intervention.
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