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Intestinal Phosphorus Absorption in Chronic Kidney Disease
Chronic kidney disease (CKD) affects approximately 10% of adults worldwide. Dysregulation of phosphorus homeostasis which occurs in CKD leads to development of CKD-Mineral Bone Disorder (CKD-MBD) and contributes to increased morbidity and mortality in these patients. Phosphorus is regulated by multi...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213936/ https://www.ncbi.nlm.nih.gov/pubmed/30249044 http://dx.doi.org/10.3390/nu10101364 |
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author | Stremke, Elizabeth R. Hill Gallant, Kathleen M. |
author_facet | Stremke, Elizabeth R. Hill Gallant, Kathleen M. |
author_sort | Stremke, Elizabeth R. |
collection | PubMed |
description | Chronic kidney disease (CKD) affects approximately 10% of adults worldwide. Dysregulation of phosphorus homeostasis which occurs in CKD leads to development of CKD-Mineral Bone Disorder (CKD-MBD) and contributes to increased morbidity and mortality in these patients. Phosphorus is regulated by multiple hormones (parathyroid hormone (PTH), 1,25-dihyxdroxyvitamin D (1,25D), and fibroblast growth factor 23 (FGF23)) and tissues (kidney, intestine, parathyroid glands, and bone) to maintain homeostasis. In health, the kidneys are the major site of regulation for phosphorus homeostasis. However, as kidney function declines, the ability of the kidneys to adequately excrete phosphorus is reduced. The hormonal changes that occur with CKD would suggest that the intestine should compensate for impaired renal phosphorus excretion by reducing fractional intestinal phosphorus absorption. However, limited studies in CKD animal models and patients with CKD suggest that there may be a break in this homeostatic response where the intestine fails to compensate. As many existing therapies for phosphate management in CKD are aimed at reducing absolute intestinal phosphorus absorption, better understanding of the factors that influence fractional and absolute absorption, the mechanism by which intestinal phosphate absorption occurs, and how CKD modifies these is a much-needed area of study. |
format | Online Article Text |
id | pubmed-6213936 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-62139362018-11-06 Intestinal Phosphorus Absorption in Chronic Kidney Disease Stremke, Elizabeth R. Hill Gallant, Kathleen M. Nutrients Review Chronic kidney disease (CKD) affects approximately 10% of adults worldwide. Dysregulation of phosphorus homeostasis which occurs in CKD leads to development of CKD-Mineral Bone Disorder (CKD-MBD) and contributes to increased morbidity and mortality in these patients. Phosphorus is regulated by multiple hormones (parathyroid hormone (PTH), 1,25-dihyxdroxyvitamin D (1,25D), and fibroblast growth factor 23 (FGF23)) and tissues (kidney, intestine, parathyroid glands, and bone) to maintain homeostasis. In health, the kidneys are the major site of regulation for phosphorus homeostasis. However, as kidney function declines, the ability of the kidneys to adequately excrete phosphorus is reduced. The hormonal changes that occur with CKD would suggest that the intestine should compensate for impaired renal phosphorus excretion by reducing fractional intestinal phosphorus absorption. However, limited studies in CKD animal models and patients with CKD suggest that there may be a break in this homeostatic response where the intestine fails to compensate. As many existing therapies for phosphate management in CKD are aimed at reducing absolute intestinal phosphorus absorption, better understanding of the factors that influence fractional and absolute absorption, the mechanism by which intestinal phosphate absorption occurs, and how CKD modifies these is a much-needed area of study. MDPI 2018-09-23 /pmc/articles/PMC6213936/ /pubmed/30249044 http://dx.doi.org/10.3390/nu10101364 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Stremke, Elizabeth R. Hill Gallant, Kathleen M. Intestinal Phosphorus Absorption in Chronic Kidney Disease |
title | Intestinal Phosphorus Absorption in Chronic Kidney Disease |
title_full | Intestinal Phosphorus Absorption in Chronic Kidney Disease |
title_fullStr | Intestinal Phosphorus Absorption in Chronic Kidney Disease |
title_full_unstemmed | Intestinal Phosphorus Absorption in Chronic Kidney Disease |
title_short | Intestinal Phosphorus Absorption in Chronic Kidney Disease |
title_sort | intestinal phosphorus absorption in chronic kidney disease |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213936/ https://www.ncbi.nlm.nih.gov/pubmed/30249044 http://dx.doi.org/10.3390/nu10101364 |
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