Wolf Laboratory

General information

Myles Wolf, MD, MMSc
Associate Professor, Medicine / Nephrology
Director, Clinical Research

Administrative Assistant: Christina Ribao
Clinical Research Building
1120 NW 14th Street, Suite 721
Miami, FL 33136
Locator Code: C-221
Phone: 305-243-7745
Fax: 305-243-8914
Email: CRibao@med.miami.edu

Research Interests

• Mineral metabolism in chronic kidney disease
• FGF-23, phosphorus and vitamin D physiology

Keywords and Phrases

• FGF-23
• Phosphorus
• Vitamin D
• Parathyroid hormone
• Calcium
• Epidemiology
• Physiology

Contact Information

Office location: Clinical Research Building
1120 NW 14^th Street, Suite 721
Miami, FL 33136
Phone: (305) 243-7760
E-mail: mwolf2@med.miami.edu

Members

Research

Fibroblast growth factor-23 (FGF-23) is a recently discovered hormone that regulates serum phosphate levels by modulating urinary phosphate excretion and 1,25-dihydroxyvitamin D (1,25D) synthesis.  Progressive increases in FGF-23 levels beginning in early CKD appear to help maintain normophosphatemia in the face of declining nephron mass and thus, markedly increased FGF-23 levels are detectable long before hyperphosphatemia first appears. Studies from our group and others suggest that increased FGF-23 levels in normophosphatemic CKD patients are associated with kidney disease progression, left ventricular hypertrophy, coronary artery calcification, and increased mortality. The latter demonstrated a strong "dose-response" relationship, including a 6-fold greater risk of death among those with the highest compared to the lowest FGF-23 levels that was independent of serum phosphate.

Our group is dedicated to advancing clinical research of FGF-23 focusing on its role in normal physiology, its role in CKD, and understanding the potential links between FGF-23 excess and adverse clinical outcomes.  We are engaged in a broad array of human research studies spanning from small human physiological studies on the clinical research center to cross-sectional and larger prospective epidemiological studies and also randomized controlled trials.  The overarching goal of these complementary multidisciplinary efforts is to develop a deeper understanding of FGF-23 physiology in human health and disease and to develop strategies to employ FGF-23 measurements in clinical practice in the future.  There are opportunities for medical students, residents and fellows to become involved in clinical research on our team.

Selected Publications

• Isakova T, Gutiérrez OM, Chang Y, Shah A, Tamez H, Smith K, Thadhani R, Wolf M. Phosphorus binders and survival on hemodialysis. J Am Soc Nephrol 2008: In press.
• Gutierrez O. M., Mannstadt M, Isakova T, Rauh-Hain JA, Tamez H, Shah A, Smith K, Lee H, Thadhani R, Juepner H, Wolf M. (2008). "Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis." N Engl J Med 359(6): 584-92.
• Gutierrez, O. M., Isakova T, Andress DL, Levin A, Wolf M. (2008). "Prevalence and severity of disordered mineral metabolism in Blacks with chronic kidney disease." Kidney Int 73(8): 956-62.   
• Isakova, T., Gutierrez O, Shah A, Castaldo L, Holmes J, Lee H, Wolf M. (2008). "Postprandial mineral metabolism and secondary hyperparathyroidism in early CKD." J Am Soc Nephrol 19(3): 615-23.
• Wolf, M., Betancourt J, Chang Y, Shah A, Teng M, Tamez H, Guttierez OM, Camargo CA, Melamed M, Norris K, Stampfer MJ, Powe NR, Thadhani R. (2008). "Impact of activated vitamin D and race on survival among hemodialysis patients." J Am Soc Nephrol 19(7): 1379-88.
• Wolf, M., Shah A, Gutierrez, OM, Ankers E, Monroy M, Tamez H, Steele D, Chang Y, Camargo CA, Tonelli M, Thadhani R. (2007). "Vitamin D levels and early mortality among incident hemodialysis patients." Kidney Int 72(8): 1004-13.
• Bhan, I., Shah A, Holmes J, Isakova T, Gutierrez O, Burnett SA, Jeupner H, Wolf M. (2006). "Post-transplant hypophosphatemia: Tertiary 'Hyper-Phosphatoninism'?" Kidney Int 70(8): 1486-94.
• Gutierrez, O., Isakova T, Rhee E, Shah A, Holmes J, Collerone G, Jeupner H, Wolf, M. (2005). "Fibroblast growth factor-23 mitigates hyperphosphatemia but accentuates calcitriol deficiency in chronic kidney disease." J Am Soc Nephrol 16(7): 2205-15.