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Review
. 2025 Jul 25:S1530-891X(25)00973-5.
doi: 10.1016/j.eprac.2025.07.015. Online ahead of print.

Diagnosis and Management of Hypophosphatemic Disorders

Eva S Liu  1
Affiliations
Review

Diagnosis and Management of Hypophosphatemic Disorders

Eva S Liu. Endocr Pract. .

Abstract

In addition to being an essential component of the mineralized skeleton, phosphate plays a role in different physiologic and cellular functions. Several different mineral-regulating hormones, including 1,25-dihydroxyvitamin D, parathyroid hormone, and fibroblast growth factor 23, modulate serum phosphate levels predominantly at the level of the bone, kidney, and intestine. Impaired serum phosphate levels can lead to nonspecific symptoms, and serum phosphate levels are not routinely measured in laboratory analyses; therefore, disorders of hypophosphatemia are often overlooked during patient evaluations. In the past few decades, significant progress has been made in identifying the genetic causes of and novel therapies for hypophosphatemic disorders. In this review, the regulation of phosphate homeostasis, clinical presentation, workup, disorders, and treatment of hypophosphatemia will be discussed.

Keywords: FGF23; burosumab; hypophosphatemia; osteomalacia; rickets; vitamin D.

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Conflict of interest statement

Disclosure Eva Liu serves on the Data and Safety Monitoring Board for Inozyme.

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References

    1. Nordin BEC Calcium, phosphate, and magnesium metabolism : clinical physiology and diagnostic procedures. (Churchill Livingstone; distributed in the United States of America by Longman, 1976).
    1. Tenenhouse HS Cellular and molecular mechanisms of renal phosphate transport. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research 12, 159–164, doi: 10.1359/jbmr.1997.12.2.159 (1997). - DOI - PubMed
    1. Sabbagh Y, Giral H, Caldas Y, Levi M & Schiavi SC Intestinal phosphate transport. Adv Chronic Kidney Dis 18, 85–90, doi: 10.1053/j.ackd.2010.11.004 (2011). - DOI - PMC - PubMed
    1. Murer H, Hernando N, Forster I & Biber J Proximal tubular phosphate reabsorption: molecular mechanisms. Physiological reviews 80, 1373–1409 (2000). - PubMed
    1. Kempson SA et al. Parathyroid hormone action on phosphate transporter mRNA and protein in rat renal proximal tubules. The American journal of physiology 268, F784–791 (1995). - PubMed

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