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Phosphate homeostasis and its role in bone health

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An Erratum to this article was published on 06 July 2017

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.

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Author information

Authors and Affiliations

  1. Pediatric Nephrology Unit, Clinics Hospital, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Maria Goretti M. G. Penido

  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

    Uri S. Alon

Authors
  1. Maria Goretti M. G. Penido
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  2. Uri S. Alon
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Corresponding author

Correspondence to Uri S. Alon.

Additional information

Answers:

A, 3; B, 2; C, 3; D, 1; E, 3.

An erratum to this article is available at http://dx.doi.org/10.1007/s00467-017-3713-5.

Questions (answers are provided following the reference list)

Questions (answers are provided following the reference list)

  1. A.

    Phosphate transport in the intestine is accomplished by:

  2. 1.

    NaPi-IIa (SLC34A1)

  3. 2.

    NaPi-IIc (SLC34A3)

  4. 3.

    NaPi-IIb (SLC34A2)

  5. 4.

    All of them

  6. B.

    The role of phosphate in growth plate physiology involves:

    1. 1.

      Chondrocyte proliferation

    2. 2.

      Hypertrophic chondrocyte apoptosis

    3. 3.

      Accumulation of osteoid

    4. 4.

      Vascular maturation

  7. C.

    The more important regulator of phosphorus transporter in the gut is:

  8. 1.

    PTH

  9. 2.

    Dietary phosphate

  10. 3.

    1,25(OH)2D3

  11. 4.

    Phosphatonins

  12. D.

    The main P transporters in the kidney are:

  13. 1.

    NaPiIIa and NaPiIIc

  14. 2.

    NaPiIIa and NaPiIIb

  15. 3.

    NaPiIIb and NaPiIIc

  16. 4.

    FGF-23

  17. E.

    What is not true regarding FGF-23:

  18. 1.

    It needs the cofactor Klotho to exert its effect

  19. 2.

    It diminishes the production of calcitriol

  20. 3.

    It increases secretion of PTH

  21. 4.

    Increased oral phosphate intake increases serum levels of FGF-23

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Penido, M.G.M.G., Alon, U.S. Phosphate homeostasis and its role in bone health. Pediatr Nephrol 27, 2039–2048 (2012). https://doi.org/10.1007/s00467-012-2175-z

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  • DOI: https://doi.org/10.1007/s00467-012-2175-z

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