PMID: 18407115Oct 1, 1992Paper

Phosphate homeostasis, 1,25-dihydroxyvitamm D(3), and hyperparathyroidism in early chronic renal failure

Trends in Endocrinology and Metabolism : TEM
J P BonjourR Rizzoli

Abstract

In early chronic renal failure, low plasma levels of calcitriol (1,25[OH](2)D(3)) do not seem to be merely the consequence of a reduced mass of functional nephrons. Indeed, this alteration can be considered as a compensatory mechanism, as analyzed according to a new concept of inorganic phosphate (P(i)) homeostasis that integrates both 1,25(OH)(2)D(3) production and renal P(i) reabsorption as essential regulating elements. Accordingly, the observed reduction in the renal production of 1,25(OH)(2)D(3) that occurs concomitantly with a decrease in tubular P(i) reabsorptive capacity (TmP(i)/GFR) may well represent a secondary adaptive response to a primary alteration in P(i) homeostasis. This crucial alteration in P(i) homeostasis would consist of an overload of a putative regulated intracellular P(i) pool, the localization of which remains to be determined. The observed hypophosphatemia, hypocalcemia, and PTH hypersecretion would represent alterations secondary to a low TmP(i)/GFR and to reduced 1,25(OH)(2)D(3) production. According to this pathophysiologic sequence, 1,25(OH)(2)D(3), rather than PTH as proposed in a former theory, would be "traded off" to preserve P(i) homeostasis in early chronic renal failure. Both theories pred...Continue Reading

References

Jun 1, 1988·Kidney International·D A Feinfeld, L M Sherwood
Oct 1, 1986·The Journal of Clinical Investigation·S Lopez-HilkerE Slatopolsky
Aug 1, 1968·The Journal of Clinical Investigation·E SlatopolskyN S Bricker
May 1, 1966·The Journal of Clinical Investigation·E SlatopolskyN S Bricker

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Citations

Jul 9, 2004·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·Laurent C DukasHannes B Stähelin
Jun 4, 2005·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·Laurent DukasHannes B Stähelin
Nov 1, 1995·Bone·J P BonjourR Rizzoli

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