A Practical Clinical Approach to Paediatric Phosphate Disorders

Abstract

Phosphate metabolism is critical to multiple systems and cellular functions. Disruption of any point in the pathways of phosphate metabolism may cause serum phosphate abnormalities and resultant acute or chronic clinical conditions. The study of phosphate disorders has revealed a wealth of information regarding normal phosphate physiology. Careful evaluation of affected patients based on pathophysiologic assessments will usually identify the aetiology of hypophosphataemia or hyperphosphataemia, which is important to guide appropriate therapy. Because of the relative importance of chronic hypophosphataemia and hyperphosphataemia to bone disease, much of this chapter will focus on chronic disorders, especially those mediated by excess or deficient fibroblast growth factor 23 functioning.

Calcium and phosphorus bioaccessibility from different amino acid-based medical nutrition formulas for infants and children under in vitro digestive conditions

“…Mineral bioavailability from food is important for all ages, but particularly for infants and young children [1]. Mineral bioavailability is influenced by many factors, including the food matrix and (its) viscosity, food processing, mineral composition (chemical source of salt and concentration), coingestion with other food items, and route of administration (e.g., oral intake vs. post pyloric tube feeding) [2,3].…”

“…Fanconi syndrome. The clinical sequelae of hypocalcemia and/or hypophosphatemia can involve defective bone mineralization and the rickets phenotype [1]. Calcium influences phosphate absorption and vice versa.…”

Rare cause of pathological fracture in adults as hypophosphatemic rickets

“…Phosphate plays a critical role in bone mineralization and its homeostasis is maintained by dietary intake, gastrointestinal absorption, renal re-absorption, and renal excretion. 1,2 Blood phosphate concentration is maintained by these systems, as well as the movement of phosphate in and out of bone and the intracellular space. Hypophosphatemia can occur as a result of low dietary intake, decreased gastrointestinal absorption, or lack of renal conservation.…”