scholarly journals Fractional Excretion of Phosphate

2020 ◽  
Author(s):  
Keyword(s):  
Fractional Excretion ◽  
Fractional Excretion Of Phosphate

Fibroblast growth factor 23 and its role in phosphate homeostasis in growing children compared to adults

2020 ◽  
Vol 33 (8) ◽  
pp. 1065-1071
Author(s):  
Marjan Jeddi ◽  
Maryam Heidari ◽  
Neda Hatami ◽  
Gholam Hossein Ranjbar Omrani
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Fibroblast Growth Factor 23 ◽  
Fractional Excretion ◽  
Cross Sectional Study ◽  
Fibroblast Growth ◽  
Sectional Study ◽  
Phosphate Homeostasis ◽  
Cross Sectional ◽  
Fractional Excretion Of Phosphate

AbstractObjectivesPhosphate is essential for skeletal mineralization, which is regulated by parathyroid hormone, calcitriol and fibroblast growth factor 23 (FGF23). Serum phosphate is physiologically higher in younger children, but factors that contribute to this physiological state are poorly understood. This study aimed to evaluate phosphate and its regulators in children compared with adults.Materials and methodsThe participants were children aged 3–11 years and adults older than 20 years of age. Biochemical parameters including calcium, phosphorus, alkaline phosphatase, FGF23, and vitamin D were measured. Fractional excretion of phosphate was calculated, using serum and urine phosphate and creatinine.ResultsThis cross-sectional study was conducted on 45 children (mean age: 9.0 ± 2.1) and 44 adults (mean age: 38.9 ± 11.1). The children had higher serum calcium, phosphate, alkaline phosphatase, and FGF23 (p < 0.001), but fractional excretion of phosphate was greater in adults (14.1 ± 5.7, 11.4 ± 4.4, p = 0.019, 95% confidence interval [CI]: −0.7 to −0.2). Of all individuals, 61.8% had vitamin D deficiency. By multiple regression analysis, entering age, calcium, phosphate, and vitamin D level, the only independent predictor of FGF23 was 1, 25 dihydroxy-vitamin D3 (β: 0.78, p < 0.001, 95% CI: 0.5–1.1, R2: 0.59 for children, and β: 0.59, p < 0.001, 95% CI: 0.5–1.4, R2: 0.45 for adults).ConclusionAs far as we know, there is little information regarding the role of FGF23 in physiologic state. In this cross-sectional study no association was found between FGF23 and urinary phosphate excretion in growing children. Further studies with more detail are essential to evaluate phosphate homeostasis during childhood.

Mechanism of phosphaturia elicited by administration of phosphonoformate in vivo

1988 ◽  
Vol 255 (5) ◽  
pp. F984-F994 ◽  
Author(s):  
M. VanScoy ◽  
M. Loghman-Adham ◽  
M. Onsgard ◽  
M. Szczepanska-Konkel ◽  
S. Homma ◽  
...  
Keyword(s):  
Direct Action ◽  
Fractional Excretion ◽  
Proximal Tubules ◽  
Camp Phosphodiesterase ◽  
Luminal Side ◽  
Metabolic Transformation ◽  
Rat Renal Cortical Slices ◽  
Fractional Excretion Of Phosphate

We examined whether phosphonoformate (PFA) can cause phosphaturia through its direct action on brush-border membrane (BBM) in vivo. Infusion of PFA or of parathyroid hormone (PTH) to thyroparathyroidectomized rats caused a marked increase in fractional excretion of phosphate without changes in excretion of Na+ or of GFR. The PFA-induced phosphaturia was not accompanied by an increase in urinary adenosine-3',5'-cyclic monophosphate (cAMP); moreover, PFA added in vitro did not influence the PTH-sensitive adenylate cyclase and cAMP-phosphodiesterase in proximal convoluted tubules. In BBM vesicles (BBMV) from rats with PFA-elicited phosphaturia, neither the rate of Na+-Pi symport nor Na+-dependent binding of [14C]PFA on BBMV was changed, whereas in BBMV from PTH-infused rats the Vmax of Na+-Pi symport decreased. PFA is almost completely ultrafiltrable; no metabolic transformation of PFA was detected after [14C]PFA exposure to rat renal cortical slices, homogenate, or to blood. We conclude that PFA causes phosphaturia by direct inhibition of Na+-Pi symport across BBM in proximal tubules, acting from the luminal side. Thus PFA (foscarnet) has a unique direct mechanism of phosphaturic effect, via its action on Pi reabsorption in proximal tubules in vivo.

scholarly journals Dopamine enhances the phosphaturic response to parathyroid hormone in phosphate-deprived rats.

1992 ◽  
Vol 2 (9) ◽  
pp. 1423-1429
Author(s):  
J Isaac ◽  
T J Berndt ◽  
S L Chinnow ◽  
G M Tyce ◽  
T P Dousa ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Fractional Excretion ◽  
Phosphate Transport ◽  
Dopamine Synthesis ◽  
Dopamine Infusion ◽  
Phosphate Deprivation ◽  
Dietary Phosphate ◽  
Urinary Dopamine ◽  
Fractional Excretion Of Phosphate ◽  
High Phosphate

Phosphate deprivation results in a resistance to the phosphaturic effect of parathyroid hormone. Dopamine is phosphaturic and is synthesized by kidney proximal tubule, the nephron subsegment where parathyroid hormone inhibits phosphate transport. Thus, to test the hypothesis that phosphate deprivation is associated with low intrarenal dopamine synthesis and that dopamine infusion will overcome the resistance to the phosphaturic response to parathyroid hormone, the following study was performed. The effect of dietary phosphate intake on intrarenal dopamine synthesis, as reflected by urinary dopamine excretion, was determined. Rats were placed in metabolic cages (N = 5) and were fed a low-phosphate diet (0.07% Pi) for 4 days and then a high-phosphate diet (1.8% Pi) for 4 days. Twenty-four-hour urinary dopamine excretion was significantly lower in rats fed a low-phosphate diet (2.53 +/- 0.06 versus 4.10 +/- 0.30 micrograms/day). Further, the effect of dopamine infusion on the blunted phosphaturic response to parathyroid hormone was studied in rats fed a low-phosphate diet for 1, 2, and 3 days. Control clearances were taken 2 h after thyroparathyroidectomy; then, parathyroid hormone (33 U/kg plus 1 U/kg/min), dopamine (25 micrograms/kg/min), or parathyroid hormone plus dopamine were infused for 60 min. Changes in the fractional excretion of phosphate were significantly greater in rats fed a low-phosphate diet infused with parathyroid hormone plus dopamine than in rats fed a low-phosphate diet infused with parathyroid hormone alone (delta 27.9 +/- 5.8 versus 11.2 +/- 2.6% for day 1; 28.4 +/- 1.4 versus 7.1 +/- 3.6% for day 2; and 10.7 +/- 2.8 versus -0.2 +/- 0.2% for day 3; N = 5 for all groups).(ABSTRACT TRUNCATED AT 250 WORDS)

P0894OBESITY IMPAIRS THE ACUTE RESPONSE TO AN ORAL PHOSPHATE CHALLENGE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mandy Turner ◽  
Christine White ◽  
Patrick Norman ◽  
Corinne Babiolakis ◽  
Michael Adams ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
High Risk ◽  
Kidney Function ◽  
Area Under The Curve ◽  
Fractional Excretion ◽  
Low Risk ◽  
Normal Kidney ◽  
Phosphate Excretion ◽  
Fractional Excretion Of Phosphate ◽  
Age And Sex

Abstract Background and Aims T Obesity is an increasing health problem world-wide. People who are overweight or obese are at greater risk of developing chronic diseases including cardiovascular disease (CVD). Factors associated with dysregulated phosphate metabolism have been linked to the presence of vascular calcification in people with type 2 diabetes (T2D) with normal kidney function. Insulin resistance and abdominal obesity are associated with increased circulating levels of phosphaturic hormones including fibroblast growth factor 23 (FGF-23) and parathyroid hormone (PTH). Abnormalities in phosphate regulation may not be reflected in single circulating measurements of serum phosphate, but can be revealed by the acute circulating and mineral response to an oral challenge of phosphate. The aim of this study was to determine if obesity and insulin resistance impact the acute capacity to excrete an oral phosphate challenge. Method Community-dwelling people (N=78) free of T2D and symptomatic CVD (∼10 males and ∼10 females from each decade between 40 and 80 years) with normal kidney function were recruited from Kingston, Ontario, Canada. Following a 12-hour fast, participants consumed a 1250 mg phosphate drink (sodium phosphate) where blood and urine were collected at baseline, 1, 2 and 3 hours following the oral challenge. Participants with a high-risk metabolic profile characterized by an elevated waist-to-height ratio (WHtR) (&gt; 0.58) were matched by age and sex to participants with a low risk WHtR (&lt;0.5). Results The results reveal a significant impact of obesity on phosphate excretion in response to an oral phosphate challenge. There was an association between WHtR ratio and the level of iFGF-23 (R=-0.34 p&lt;0.01) but not PTH. After adjustment for age and sex, WHtR ratio was inversely correlated with urinary phosphate excretion in response to the phosphate challenge (R=-0.29, p=0.02) and the change in fractional excretion of phosphate (r=-0.34, p=0.007). From the larger cohort, an age- and sex- matched subset was selected for 12 high risk and 12 low risk metabolic profiles with WHtR of 0.66±0.02 and 0.46±0.01, respectively. Kidney function was the same between the two groups (eGFR 92.3±13.1 versus 95.8±13.6 ml/min/1.73m2 respectively) but high risk participants had significantly higher homeostatic model assessment of insulin resistance (HOMA-IR) (1.61±0.81 versus 0.68±0.3, p&lt;0.01). Participants with a high risk metabolic profile had a greater increase in serum phosphate from baseline (29% increase in the area under the curve, p=0.04) and a significantly blunted increase in the fractional excretion of phosphate in response to the oral phosphate challenge (35% reduction in area under the curve [AUC], p=0.03) compared to the matched low risk profile participants. Conclusion Overweight/obese individuals demonstrate impaired response to an oral phosphate challenge, whereby phosphate excretion was impaired and there was increased exposure to new circulating phosphate. An impaired acute phosphate response may contribute to the initiation or propagation of vascular calcification. Dysregulated phosphate homeostasis may be an under-recognized cardiovascular risk factor in obese people that could be modified by diet and weight loss. Whether insulin enhances renal phosphate reabsorption requires further study.

scholarly journals Fractional Excretion of Phosphate (FeP) Is Associated with End-Stage Renal Disease Patients with CKD 3b and 5

2019 ◽  
Vol 8 (7) ◽  
pp. 1026 ◽  
Author(s):  
Antonio Bellasi ◽  
Lucia Di Micco ◽  
Domenico Russo ◽  
Emanuele De Simone ◽  
Mattia Di Iorio ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Fibroblast Growth Factor 23 ◽  
Fractional Excretion ◽  
High Risk Population ◽  
Related Factor ◽  
Ckd Progression ◽  
Historical Cohort ◽  
Increased Risk ◽  
Ckd Stage ◽  
Fractional Excretion Of Phosphate

Background: The perturbation of phosphate homeostasis portends unfavorable outcomes in chronic kidney disease (CKD). However, the absence of randomized clinical trials (RCT) fuels the discussion of whether phosphate or some other phosphorous-related factor(s) such as fibroblast growth factor 23 (FGF-23) mediates the cardiovascular and systemic toxicity. We herein test whether the fractional excretion of phosphate (FeP) as a marker of renal stress to excrete phosphorous predicts unfavorable outcomes in CKD patients. Methods: Retrospective, cross-sectional observational study. For current analysis, an historical cohort of 407 records of CKD stage 3b-5 patients attending between January 2010 and October 2015 at the Nephrology Unit of Solofra (AV), Italy were utilized. Demographic, clinical, laboratory, and outcome data were identified through the subjects’ medical records. We tested whether quartiles of FeP are associated with the risk of CKD progression or all causes of death. Parametric as well as non-parametric tests, linear and logistic regression, as well as survival analysis were utilized. Results: Overall, we investigated middle-age (mean 66.0, standard deviation 12.3 years) men and women (male 43%) with CKD stage 3b to 5 (creatinine clearance 32.0 (13.3) mL/min). Older age, lower diastolic blood pressure, poor renal function, as well as higher serum phosphate were associated with FeP. Patients with higher FeP were at an increased risk of starting dialysis or dying (hazard ratio 2.40; 95% confidence interval (1.44, 3.99)). Notably, when the two endpoints were analyzed separately, FeP was associated with renal but not all-cause survival. Conclusion: FeP is associated with ESRD, but not all-cause mortality risk in a large cohort of moderate to advanced CKD patients. Future efforts are required to validate FeP as a marker of nephron stress and risk factor for CKD progression in this high-risk population.

Calcitonin inhibits Na+ gradient-dependent phosphate uptake across renal brush-border membranes

1987 ◽  
Vol 252 (4) ◽  
pp. F598-F604 ◽  
Author(s):  
A. N. Yusufi ◽  
T. J. Berndt ◽  
N. Murayama ◽  
F. G. Knox ◽  
T. P. Dousa
Keyword(s):  
Brush Border ◽  
Brush Border Membrane ◽  
Marked Decrease ◽  
Phosphate Uptake ◽  
Fractional Excretion ◽  
Proximal Tubules ◽  
Cortical Tissue ◽  
Pi Transport ◽  
Renal Brush Border Membranes ◽  
Fractional Excretion Of Phosphate

This study was undertaken to determine whether calcitonin inhibits Na+-(Pi) cotransport across luminal brush-border membrane (BBM) of proximal tubules. Further, we determined the relative inhibitions of inorganic phosphate (Pi) transport in BBM vesicles (BBMV) derived from superficial cortical tissue (BBMV-SC) and juxtamedullary tissue (BBMV-JM). The effects of maximally phosphaturic doses of calcitonin were compared with those of parathyroid hormone (PTH). Experiments were performed in acutely thyroparathyroidectomized (TPTX) rats fed either normal (NPD, 0.7%) or low (LPD, 0.07%) Pi diets. After measurement of the fractional excretion of phosphate (FEPi) by clearance, the BBMV-SC and BBMV-JM were prepared from kidneys of the same animals and uptakes of 32Pi were determined. Both calcitonin and PTH inhibited BBMV transport of Pi to a greater degree in BBMV-JM than in BBMV-SC, in rats fed NPD or LPD. Kinetic analysis shows that administration of calcitonin resulted in marked decrease of apparent Vmax for Pi without any changes in apparent Km for Pi. However, in spite of a decreased capacity for Na+ gradient-dependent 32Pi uptake in BBMV-JM and much lesser in BBMV-SC in response to administration of calcitonin and PTH in Pi-deprived rats, these phosphaturic peptides did not increase FEPi. We conclude that calcitonin administration decreases the capacity for Na+-Pi cotransport across BBM in proximal tubules of the acutely TPTX rat.

Lithium clearance in water immersion-induced natriuresis in humans

1989 ◽  
Vol 66 (4) ◽  
pp. 1744-1748 ◽  
Author(s):  
T. J. Rabelink ◽  
H. A. Koomans ◽  
W. H. Boer ◽  
J. van Rijn ◽  
E. J. Dorhout Mees
Keyword(s):  
Healthy Subjects ◽  
Water Immersion ◽  
Free Water ◽  
Fractional Excretion ◽  
Lithium Clearance ◽  
Free Water Clearance ◽  
Time Control ◽  
Fractional Excretion Of Phosphate ◽  
Response To Water ◽  
Glomerulotubular Balance

Lithium clearance (CLi) has been advanced as a measure of sodium delivery from the proximal tubules. Because information on the intrarenal effects of water immersion is only limited, and available data are conflicting with respect to the effects on the proximal tubule, we examined the effects of 3 h of water immersion on renal functional parameters, including CLi, in eight healthy subjects. Studies were carried out during maximal water diuresis. Water immersion resulted in a significant increase in sodium excretion, from preimmersion values of 74.0 +/- 9.6 to 155.4 +/- 12.0 mumol/min at the third immersion hour (P less than 0.01). This natriuresis was accompanied by an increase in CLi from 26.3 +/- 1.9 (preimmersion) to 37.0 +/- 3.1 ml/min (P less than 0.01). Fractional lithium reabsorption (FRLi) decreased from 76.4 +/- 1.0 to 69.6 +/- 1.3% (P less than 0.01). None of these changes was found in eight healthy subjects undergoing a time-control study without water immersion. The large fall in FRLi found during immersion is compatible with a major resetting of the proximal glomerulotubular balance. In this regard the renal response to water immersion resembles saline expansion rather than mere intravascular expansion. The lithium data suggested a large rise in distal delivery accompanied by an almost as large rise in distal reabsorption. The free water clearance data were in agreement with this interpretation. However, no changes were found in fractional excretion of phosphate and uric acid. Therefore such a major resetting of proximal glomerulotubular balance can be doubted.(ABSTRACT TRUNCATED AT 250 WORDS)

Renal effect of vitamin D metabolites: evidence for the essential role of the 25(OH) group

1983 ◽  
Vol 244 (6) ◽  
pp. F674-F678 ◽  
Author(s):  
M. M. Friedlaender ◽  
Z. Kornberg ◽  
H. Wald ◽  
M. M. Popovtzer
Keyword(s):  
Vitamin D ◽  
Vitamin D3 ◽  
Essential Role ◽  
Fractional Excretion ◽  
Vitamin D Metabolites ◽  
Group 2 ◽  
Fractional Excretion Of Phosphate ◽  
Group 1

The effects of 1 alpha (OH)vitamin D3 [1 alpha (OH)D3] and 24,25(OH)2vitamin D3 [24,25(OH)2D3] on the phosphaturic action of parathyroid hormone (PTH) were studied in two groups of parathyroidectomized (PTX) rats. In group 1, PTX PTH-infused rats received intravenous 1 alpha (OH)D3, and in group 2, PTX PTH-infused rats received intravenous 24,25(OH)2D3. PTX PTH-infused rats served as controls. The effects of both vitamin D metabolites on renal PTH-activated adenylate cyclase (AC) were studied in vitro. In group 1, PTH increased fractional excretion of phosphate (CP/CIn) from 0.045 +/- 0.012 (+/- SE) to 0.263 +/- 0.011 (P less than 0.005). 1 alpha (OH)D3 failed to influence this response. In group 2, PTH increased CP/CIn from 0.055 +/- 0.008 to 0.289 +/- 0.027 (P less than 0.005). 24,25(OH)2D3 reduced the PTH-induced rise in CP/CIn from 0.289 +/- 0.027 to 0.192 +/- 0.021 (P less than 0.01) and decreased the urinary excretion of adenosine 3',5'-cyclic monophosphate. In vitro, 24,25(OH)2D3 blunted the PTH-activated AC, whereas 1 alpha (OH)D3 had no effect. These results show that 24,25(OH)D3, similar to two other 25(OH) metabolites of vitamin D-25(OH)vitamin D3 and 1,25(OH)2vitamin D3-suppresses the phosphaturic action of PTH, whereas 1 alpha(OH)D3, which is devoid of a 25(OH) group, lacks this effect. This suggests that a 25(OH) group is a prerequisite for the antiphosphaturic effect of vitamin D, whereas the 1 alpha (OH) group is not essential for this action.

INCREASED FRACTIONAL EXCRETION OF PHOSPHATE AND BETA2-MICROGLOBULIN IN UNILATERAL RENAL DISEASE

1983 ◽  
Vol 72 (6) ◽  
pp. 889-894 ◽  
Author(s):  
A. APERIA ◽  
I. WIKSTAD ◽  
O. BROBERGER
Keyword(s):  
Renal Disease ◽  
Fractional Excretion ◽  
Fractional Excretion Of Phosphate

Resistance to the phosphaturic effect of parathyroid hormone in the hamster

1979 ◽  
Vol 237 (3) ◽  
pp. F175-F181
Author(s):  
C. A. Harris ◽  
J. F. Seely
Keyword(s):  
Parathyroid Hormone ◽  
Fractional Excretion ◽  
Free Access ◽  
Calcium Excretion ◽  
Renal Tubular Cell ◽  
Acid Base ◽  
Significant Difference ◽  
Renal Tubular ◽  
Fractional Excretion Of Phosphate ◽  
Access To Food

The renal effects of parathyroid hormone (PTH) and dibutyryl 3'5'-cyclic AMP (DBcAMP) were studied in thyroparathyroidectomized hamsters. The hamsters were permitted free access to food and water or fasted for 16 h. PTH caused a phosphaturia in the fed hamster (fractional excretion of phosphate (FEPO4) increased from 5.8 +/- 1.3 to 27.4 +/- 4.6%, P less than 0.001) but not in the fasted hamster (from 9.9 +/- 2.5 to 12.4 +/- 2.5%, NS), whereas calcium excretion decreased significantly in both groups. There was no significant difference in blood acid-base or phosphate levels between the two groups. Insulin did not restore the phosphaturic response to PTH (FEPO4 from 7.7 +/- 2.6 to 5.3 +/- 1.7%), whereas phosphate or NH4Cl infusion did, FEPO4 increasing from 20.9 +/- 3.1 to 38.1 +/- 5.4% (P less than 0.02) and from 19.5 +/- 3.8 to 39.0 +/- 7.5%, respectively. DBcAMP caused a phosphaturia both in the fasted (from 9.6 +/- 2.7 to 20.1 +/- 4.5%, P less than 0.01) and fed (from 2.5 +/- 0.5 to 10.7 +/- 1.5%, P less than 0.02) hamster. A fasting state of up to 64 h did not produce resistance to PTH in the rat. It is concluded that fasting produces resistance to the phosphaturic but not the calcium-retaining effects of PTH in the hamster. The resistance may occur, at least partly, prior to the production of cAMP within the renal tubular cell.

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