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Pediatr Nephrol. 2012 Nov;27(11):2039-2048. doi: 10.1007/s00467-012-2175-z. Epub 2012 May 3.

Phosphate homeostasis and its role in bone health.

Author information

1
Pediatric Nephrology Unit, Clinics Hospital, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
2
Bone and Mineral Disorders Clinic, Section of Pediatric Nephrology, Children's Mercy Hospital and Clinics, University of Missouri at Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA. ualon@cmh.edu.

Abstract

Phosphate is one of the most abundant minerals in the body, and its serum levels are regulated by a complex set of processes occurring in the intestine, skeleton, and kidneys. The currently known main regulators of phosphate homeostasis include parathyroid hormone (PTH), calcitriol, and a number of peptides collectively known as the "phosphatonins" of which fibroblast growth factor-23 (FGF-23) has been best defined. Maintenance of extracellular and intracellular phosphate levels within a narrow range is important for many biological processes, including energy metabolism, cell signaling, regulation of protein synthesis, skeletal development, and bone integrity. The presence of adequate amounts of phosphate is critical for the process of apoptosis of mature chondrocytes in the growth plate. Without the presence of this mineral in high enough quantities, chondrocytes will not go into apoptosis, and the normal physiological chain of events that includes invasion of blood vessels and the generation of new bone will be blocked, resulting in rickets and delayed growth. In the rest of the skeleton, hypophosphatemia will result in osteomalacia due to an insufficient formation of hydroxyapatite. This review will address phosphate metabolism and its role in bone health.

PMID:
22552885
PMCID:
PMC3461213
DOI:
10.1007/s00467-012-2175-z
[Indexed for MEDLINE]
Free PMC Article

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