Raikou VD. Serum phosphate and chronic kidney and cardiovascular disease: Phosphorus potential implications in general population. World J Nephrol 2021; 10(5): 76-87 [PMID: 34631478 DOI: 10.5527/wjn.v10.i5.76]
Corresponding Author of This Article
Vaia D Raikou, PhD, Chief Doctor, Department of Nephrology, Doctors’ Hospital, 26 Kefallinias, Athens 11257, Greece. vraikou@med.uoa.gr
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Sep 25, 2021; 10(5): 76-87 Published online Sep 25, 2021. doi: 10.5527/wjn.v10.i5.76
Serum phosphate and chronic kidney and cardiovascular disease: Phosphorus potential implications in general population
Vaia D Raikou
Vaia D Raikou, Department of Nephrology, Doctors’ Hospital, Athens 11257, Greece
Author contributions: Raikou VD wrote this manuscript.
Conflict-of-interest statement: The author declares no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vaia D Raikou, PhD, Chief Doctor, Department of Nephrology, Doctors’ Hospital, 26 Kefallinias, Athens 11257, Greece. vraikou@med.uoa.gr
Received: February 27, 2021 Peer-review started: February 27, 2021 First decision: May 6, 2021 Revised: May 20, 2021 Accepted: July 23, 2021 Article in press: July 23, 2021 Published online: September 25, 2021
Abstract
It has already been established that in end-stage renal disease, hyperphosphatemia causes soft tissue calcification including vascular calcifications. It has also been supported that there is a connection between increased serum phosphate and morbidity in subjects, who suffer from renal disease. However, studies in these populations conferred mixed results. Several warnings are included in the role of serum phosphorus on cardiovascular disease in normal populations. Homeostasis of serum phosphate is obtained by the cooperation between regulatory hormones, cellular receptors and bone metabolic factors. There is the probability that one or more phosphate regulatory factors, rather than phosphate directly, may be responsible for observed associations with calcification and cardiovascular events in normal populations. Experimental studies have shown that the restriction of dietary phosphate prevents the progression of kidney dysfunction, although high dietary phosphate aggravates the renal function. In the current review, we discuss the role of serum phosphorus on progression of renal dysfunction and cardiovascular outcomes in chronic kidney disease patients and its involvement in important health risks in the general population.
Core Tip: Disordered phosphorus homeostasis in chronic kidney diseases is associated with bad outcomes including cardiovascular morbidity/mortality and progression of renal dysfunction in end-stage of renal disease. Potential health consequences in cardiovascular and kidney disease could be developed in subjects with a high intake of dietary phosphorus despite the apparently normal renal function, due mainly to abnormalities in metabolism and in regulatory factors, rather than to serum phosphorus itself. The maintenance of serum phosphorus in normal range should be obtained.
