Differential Determinants of Tubular Phosphate Reabsorption: Insights on Renal Excretion of Phosphates in Kidney Disease

American Journal of Nephrology
Nahid TabibzadehPierre Bataille

Abstract

We assessed the tubular reabsorption of phosphate (TRP) and maximal renal threshold for phosphate reabsorption to glomerular filtration rate (TmPi/GFR) and their determinants in 64 stages 2-4 chronic kidney disease (CKD) patients in order to define the early changes in phosphate metabolism in CKD. In multivariable analysis, TmPi/GFR correlates were estimated GFR (eGFR), intact parathyroid hormone (iPTH), and hemoglobin (R2 = 0.417), while TRP correlates were eGFR, iPTH, 24-h phosphaturia, and calcitriol (R2 = 0.72). This suggests that TmPi/GFR and TRP, respectively, assess hemoglobin-phosphate and bowel-kidney phosphate regulation axis. Iron supplementation based on TmPi/GFR or earlier phosphate restriction based on TRP should be investigated in view of modifying clinical outcomes in CKD.

References

Dec 23, 2004·The Journal of Clinical Endocrinology and Metabolism·Serge L FerrariRené Rizzoli
Jun 15, 2007·Proceedings of the National Academy of Sciences of the United States of America·Theresa BerndtRajiv Kumar
Aug 6, 2010·American Journal of Physiology. Renal Physiology·Vardit Lavi-MoshayoffTally Naveh-Many
Jun 19, 2013·Nature Reviews. Nephrology·Makoto Kuro-o

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Citations

Nov 16, 2018·Frontiers in Cellular Neuroscience·Yan ShiHanyu Zhu

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