TY  - CHAP
M1  - Book, Section
TI  - Disorders of Phosphorus Concentration
A1  - Anker, Naomi B.
A1  - Cho, Kerry C.
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
PY  - 2020
T2  - Current Medical Diagnosis and Treatment 2020
AB  - Plasma  phosphorus  is  mainly  inorganic  phosphate  and  represents  a  small  fraction  (less  than  0.2%)  of  total  body  phosphate.  Important  determinants  of  plasma  inorganic  phosphate  are  renal  excretion,  intestinal  absorption,  and  shift  between  the  intracellular  and  extracellular  spaces.  The  kidney  is  the  most  important  regulator  of  the  serum  phosphate  level.  PTH  decreases  reabsorption  of  phosphate  in  the  proximal  tubule  while  1,25-dihydroxyvitamin  D3  increases  reabsorption.  Renal  proximal  tubular  reabsorption  of  phosphate  is  decreased  by  volume  expansion,  corticosteroids,  and  proximal  tubular  dysfunction  (as  in  Fanconi  syndrome).  Fibroblast  growth  factor  23  (FGF23)  is  a  potent  phosphaturic  hormone.  Intestinal  absorption  of  phosphate  is  facilitated  by  active  vitamin  D.  PTH  stimulates  phosphate  release  from  bone  and  renal  phosphate  excretion;  primary  hyperparathyroidism  can  lead  to  hypophosphatemia  and  depletion  of  bone  phosphate  stores.  By  contrast,  growth  hormone  augments  proximal  tubular  reabsorption  of  phosphate.  Cellular  phosphate  uptake  is  stimulated  by  various  factors  and  conditions,  including  alkalemia,  insulin,  epinephrine,  feeding,  hungry  bone  syndrome,  and  accelerated  cell  proliferation.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2022/05/24
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1166170202
ER  -