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The Importance of Phosphate Control in Chronic Kidney Disease.

Abstract
A series of problems including osteopathy, abnormal serum data, and vascular calcification associated with chronic kidney disease (CKD) are now collectively called CKD-mineral bone disease (CKD-MBD). The pathophysiology of CKD-MBD is becoming clear with the emerging of αKlotho, originally identified as a progeria-causing protein, and bone-derived phosphaturic fibroblast growth factor 23 (FGF23) as associated factors. Meanwhile, compared with calcium and parathyroid hormone, which have long been linked with CKD-MBD, phosphate is now attracting more attention because of its association with complications and outcomes. Incidentally, as the pivotal roles of FGF23 and αKlotho in phosphate metabolism have been unveiled, how phosphate metabolism and hyperphosphatemia are involved in CKD-MBD and how they can be clinically treated have become of great interest. Thus, the aim of this review is reconsider CKD-MBD from the viewpoint of phosphorus, its involvement in the pathophysiology, causing complications, therapeutic approach based on the clinical evidence, and clarifying the importance of phosphorus management.
AuthorsKen Tsuchiya, Taro Akihisa
JournalNutrients (Nutrients) Vol. 13 Issue 5 (May 14 2021) ISSN: 2072-6643 [Electronic] Switzerland
PMID34069053 (Publication Type: Journal Article, Review)
Chemical References
  • FGF23 protein, human
  • KLB protein, human
  • Membrane Proteins
  • Parathyroid Hormone
  • Phosphates
  • Phosphorus
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23
  • Klotho Proteins
  • Calcium
Topics
  • Aging
  • Animals
  • Bone and Bones (metabolism)
  • Calcium (blood)
  • Chronic Kidney Disease-Mineral and Bone Disorder (complications)
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors
  • Humans
  • Hyperphosphatemia
  • Klotho Proteins
  • Membrane Proteins (metabolism)
  • Parathyroid Hormone
  • Phosphates (metabolism)
  • Phosphorus (blood)
  • Renal Insufficiency, Chronic (complications, physiopathology)
  • Risk Factors
  • Vascular Calcification

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