Phosphate homeostasis and disorders

Abstract

Recent studies of inherited disorders of phosphate metabolism have shed new light on the understanding of phosphate metabolism. Phosphate has important functions in the body and several mechanisms have evolved to regulate phosphate balance including vitamin D, parathyroid hormone and phosphatonins such as fibroblast growth factor-23 (FGF23). Disorders of phosphate homeostasis leading to hypo-and hyperphosphataemia are common and have clinical and biochemical consequences. Notably, recent studies have linked hyperphosphataemia with an increased risk of cardiovascular disease. This review outlines the recent advances in the understanding of phosphate homeostasis and describes the causes, investigation and management of hypo-and hyperphosphataemia.

Serum 25-Hydroxyvitamin D and the Incidence of Peripheral Artery Disease in the Elderly: The Pro.V.A Study

“…Several cross-sectional studies have found a low tion, at both the baseline and the follow-up visits (1.5% and 3.1%, respectively), we are confident that our results were negligibly influenced by our failure to measure the serum 25OHD levels at the follow-up visit. Moreover, serum phosphorus levels were not measured, although hyperphosphoremia appears to be an independent risk factor for CVD 32) . We also did not assess ABI in other ways (e.g., toe pressure versus ankle pressure) in diabetic participants or patients with diseases at high risk of vascular calcifications 18) .…”

Clinical and laboratory features associated with serum phosphate concentrations in malaria and other febrile illnesses

“…Abnormal serum phosphate levels are a common finding in seriously ill patients, and hypophosphatemia (usually defined as serum phosphate < 0.8 mmol/L) is commonly seen in patients with severe infections [1][2][3][4][5][6][7][8][9].…”

“…Phosphate is essential to the biology of life, as the fundamental energy currency of cells in adenosine triphosphate (ATP), as a critical component of nucleic acids, as a molecular switch controlling protein function, as a component of membrane phospholipids, and as a buffer to changes in pH [13]. Most phosphorous in the human body is stored in bones and teeth, and the rest is predominantly intracellular, where concentrations are 100 times greater than in plasma [9,13]. Only about 1% of body phosphorous content is contained in the plasma, but this phosphate is important because it is the medium of exchange between different body compartments, particularly when phosphate is required rapidly [9,13,14].…”

“…Most phosphorous in the human body is stored in bones and teeth, and the rest is predominantly intracellular, where concentrations are 100 times greater than in plasma [9,13]. Only about 1% of body phosphorous content is contained in the plasma, but this phosphate is important because it is the medium of exchange between different body compartments, particularly when phosphate is required rapidly [9,13,14]. Phosphate homeostasis is maintained by the action of parathyroid hormone (PTH), calcitriol, and increasingly well-characterized phosphatonin peptides, which regulate uptake from the intestine, reabsorption by the kidney, and phosphate exchange between bone and extracellular pools [9,[13][14][15].…”

Elevated Phosphate Levels Trigger Autophagy-Mediated Cellular Apoptosis in H9c2 Cardiomyoblasts

“…Approximately 80-85% of phosphate is present in the skeleton, 10-15% in soft tissues, and only <1% of phosphate circulates in the serum of a healthy adult [1]. Although the required phosphate level is about 580 mg/day, some individuals' daily phosphorus intake exceeds the upper tolerable limit (4,000 mg/day) [2].…”