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      Age-Dependent Phosphate Homeostasis Is Regulated by a Circulating Factor

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          To evaluate the age-dependent phosphate homeostasis, we studied the serum inorganic phosphate (P<sub>i</sub>) concentration in 78 recipients, aged 5–25 years, a year after renal transplantation (RT). The significant age-dependent decline of the serum P<sub>i</sub> concentration was observed in recipients (p < 0.0001) as well as in normal children. Our study revealed that a circulating factor may play a central role in the age-dependent change of phosphate regulation in human.

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          PHEX gene and hypophosphatemia.

           M Drezner (1999)
          PHEX gene and hypophosphatemia. X-linked hypophosphatemia (XLH) and tumor-induced osteomalacia (TIO) are diseases that have in common abnormal proximal renal tubular function resulting in increased renal clearance of inorganic phosphorus and hypophosphatemia. The recent discovery of the PHEX gene has provided new insights to these disorders. In this regard, identification of the PHEX gene product as a membrane-bound endopeptidase suggests that the pathophysiologic cascade underlying XLH likely involves inactivation mutations of the gene causing a failure to clear an active hormone, phosphatonin, from the circulation. The presence of this hormone through unknown mechanisms decreases the sodium-dependent phosphate cotransporter in the kidney, resulting in impaired phosphate transport. In contrast, TIO likely evolves secondary to tumor overproduction of the putative phosphatonin, which exerts physiologic function despite efforts to counteract the resultant hypophosphatemia with overproduction of PHEX transcripts that are insufficient to accommodate the enhanced substrate load. These potential pathophysiologic mechanisms for XLH and TIO provide valuable inroads to understanding phosphate homeostasis, as well as vitamin D metabolism, bone mineralization, and calcium metabolism.

            Author and article information

            S. Karger AG
            October 2002
            18 October 2002
            : 92
            : 4
            : 931-932
            aDepartment of Pediatric Nephrology, Tokyo Women’s Medical University, Tokyo, and bDepartment of Medicine, St. Luke’s International Hospital, Tokyo, Japan
            65447 Nephron 2002;92:931–932
            © 2002 S. Karger AG, Basel

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            Figures: 1, References: 4, Pages: 2
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            Short Communication

            Cardiovascular Medicine, Nephrology

            Development, PHEX gene, Phosphate


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