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. 2018;47(5):300-303.
doi: 10.1159/000488864. Epub 2018 May 18.

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

Nahid Tabibzadeh  1 , Romuald Mentaverri  2   3 , Maïté Daroux  1 , Rafik Mesbah  1 , Alexia Delpierre  1 , Jean-Gabriel Paul  4 , Valérie Deken  5 , Ziad A Massy  6   7   8 , Pierre Bataille  1
Affiliations

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

Nahid Tabibzadeh et al. Am J Nephrol. 2018.

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.

Keywords: Chronic kidney disease; Fibroblast growth factor 23; Mineral and bone disorders; Tubular phosphate reabsorption.

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