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

Tabibzadeh, Nahid; Mentaverri, Romuald; Daroux, Maïté; Mesbah, Rafik; Delpierre, Alexia; Paul, Jean-Gabriel; Deken, Valérie; Massy, Ziad A.; Bataille, Pierre

doi:10.1159/000488864

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…This finding mirrors the research by Gutierrez et al (9), Chartsrisak et al (12) and Isakova et al (10), according to which hyperphosphatemia rises with the increase in CKD stage (P = 0.001) and the decrease in glomerular filtration rate. In early-stage CKD, the phosphate metabolism is disturbed, however the serum phosphate concentration usually is maintained at the normal range as a result from the compensation for fibroblast growth factor-23 while hyperphosphatemia increases to the final stage of the kidney disease (13)(14). The prevalence of hyperphosphatemia in CKD patients is elevated with the lowering of kidney function.…”

Section: Discussionmentioning

confidence: 99%

Proportions of hyperphosphatemia in different stages of chronic kidney disease

et al. 2022

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Introduction: In chronic kidney disease (CKD) patients, calcium and phosphate homeostasis disorders occur. Decreased kidney function will result in decreased phosphate excretion. In stage 3b CKD, the kidneys are no longer able to compensate for the phosphate load sufficiently and hyperphosphatemia is resulted. Objectives: This research aimed to figure out the proportions of hyperphosphatemic patients at different levels of glomerular filtration rate in CKD. Patients and Methods: An observational study with a cross-sectional approach involving 80 CKD subjects, distributed into stage 3 (n = 20), stage 4 (n = 20), stage 5 non-dialysis (n = 20) and stage 5 dialysis CKD subjects(n = 20), at Wahidin Sudirohusodo hospital and Unhas hospital, Makassar, from April through August 2021. Phosphate concentrations were measured using ELISA (enzyme-linked immunosorbent assay) kit (Immutopics). A result of the statistical test would be significant if P < 0.05. Results: The average phosphate concentrations at stage 3, stage 4, stage 5 non-dialysis and stage 5 dialysis were 4.14 ± 1.85 mg/dL, 4.17 ± 1.12 mg/dL, 6.43 ± 3.09 md/dL and 5.42 ± 3.09 mg/dL, respectively. Based on the avergae phosphate concentration by CKD stage, stage 3 was not significantly different from stage 4 (P = 0.969), however there was a significant difference between stage 3 and stage 5 non-dialysis (P = 0.004) and also between stage 4 and stage 5 non-dialysis (P = 0.005). The proportions of hyperphosphatemic patients (serum phosphate >4.5 mg/dL) with stage 3, stage 4, stage 5 non-dialysis and stage 5 dialysis CKD were 15% (n = 3), 20% (n = 4), 75% (n = 15) and 43.3% (n = 9), respectively. Conclusion: The porportion of hyperphosphatemic subjects increased with the decline in the kidney function. Dialysis process reduces phosphate levels and the proportion of patients with hyperphosphatemia.

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Section: Discussionmentioning

confidence: 99%

Proportions of hyperphosphatemia in different stages of chronic kidney disease

et al. 2022

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“…Serum homocysteine (Hcy) is a sulfur-containing amino acid ( Brustolin et al, 2010 ). As mentioned above, serum Hcy clearance is significantly decreased in patients with CKD and patients already prone to high Hcy in the blood ( Karmin and Siow, 2018 ; Tabibzadeh et al, 2018 ). Interestingly, serum Hcy levels were found to be significantly higher in AD patients ( Baumgart et al, 2015 ), and serum Hcy levels are a strong and independent risk factor of AD and dementia ( Xue et al, 2014 ).…”

Section: The Potential Markers Related To Admentioning

confidence: 95%

A Novel Perspective Linkage Between Kidney Function and Alzheimer’s Disease

Shi

Liu

Shen

et al. 2018

Front. Cell. Neurosci.

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It has long been believed that kidney function is linked to brain activity. Clinical studies demonstrate that patients with chronic kidney disease (CKD) are more prone to cognitive impairment and Alzheimer’s disease (AD), and the degree of cognitive impairment is closely related to CKD progression and renal failure. Moreover, the fact that cognitive function in CKD patients is significantly improved after successful kidney transplantation reveals a linkage between CKD and AD. However, the mechanisms behind this linkage are unclear. The physiological function of the kidney is to maintain the stability of the internal environment, including the cerebrovascular circulation, whereas abnormal kidney function often leads to ischemia and hypoxia. Many CKD patients experience chronic hypoxia, and many urinary toxins accumulate after renal function is impaired. In this mini review, we will propose a novel perspective on the association between AD and CKD and the connection between the kidney and brain.

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“…On the other hand, the decline in urinary Ca excretion during CKD progress could be partly explained by low 1α,25-dihydroxy vitamin D [1α,25-(OH) 2 D] [17] and high parathyroid hormone (PTH) levels [18]. In the opposite, the negative correlation between urinary P excretion and the glomerular filtration rate (GFR) [17, 19] is probably due to elevated fibroblast growth factor 23 (FGF23) and PTH in response to P retention [20]. Moreover, sclerostin was found not only to inhibit the synthesis of 1α hydroxylase by cultured proximal tubular cells [21], but also to indirectly stimulate the secretion of FGF23 by osteoblasts [22].…”

Section: Introductionmentioning

confidence: 99%

The Association of Urinary Sclerostin and Renal Magnesium Handling in Type 2 Diabetic Patients with Chronic Kidney Disease

Liou

Kuo

et al. 2021

Kidney Blood Press Res

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Introduction: Sclerostin could enhance renal excretion of calcium (Ca) and phosphate (P). The association between sclerostin and magnesium (Mg) has not yet discovered. In patients with type 2 diabetes mellitus (T2DM) or chronic kidney disease (CKD), higher serum sclerostin and altered renal excretion of Ca, P, and Mg were detected. Therefore, we tried to evaluate if there was any association between sclerostin and fractional excretion of Ca, P, and Mg (FeCa, FeP, and FeMg) in T2DM with CKD. Methods: In this prospective cohort study, 43 T2DM patients without CKD or with CKD stage 1–5 were enrolled. Values of parameters, including serum and urine sclerostin, were collected at baseline and 6 months later. For baseline data, the Mann-Whitney U test, χ2 test, or Spearman’s correlation were used. For multivariate repeated measurement analysis, generalized estimating equation (GEE) model was utilized. Results: Patients with lower estimated glomerular filtration rate had higher serum sclerostin, FeP, FeMg, and lower FeCa. By correlation analysis, serum sclerostin was negatively associated with FeCa (p = 0.02) and positively associated with FeP (p = 0.002). The urine sclerostin to creatinine ratio (Uscl/Ucre) was positively correlated with FeP (p = 0.007) and FeMg (p = 0.005). After multivariate analyses by GEE model, serum sclerostin was still inversely associated with FeCa, while Uscl/Ucre was significantly associated with FeMg. On the other hand, FeP lost its associations with serum sclerostin or Uscl/Ucre. Conclusion: In our study population of T2DM patients with or without CKD, the inverse correlation between serum sclerostin and FeCa could not be explained by the calciuric effect of sclerostin. In addition, a newly discovered positive association between urinary sclerostin and FeMg indicated a possible role of urinary sclerostin in regulating renal Mg handling especially over distal convoluted tubules.

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

Cited by 4 publications

References 7 publications

Proportions of hyperphosphatemia in different stages of chronic kidney disease

Proportions of hyperphosphatemia in different stages of chronic kidney disease

A Novel Perspective Linkage Between Kidney Function and Alzheimer’s Disease

The Association of Urinary Sclerostin and Renal Magnesium Handling in Type 2 Diabetic Patients with Chronic Kidney Disease

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