Role of Phosphate in Treatment of Renal Tubular (Hypophosphataemic) Rickets and Ostemalacias

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Abstract
Three patients with types 1 and 2 renal tubular osteomalacia were studied and the relative effects of vitamin D and phosphate therapies examined. One patient demonstrated the condition of undoubted osteomalacia with normal plasma alkaline phosphatase. Phosphate therapy does not lower fecal Ca and is without significant benefit when faecal Ca is high. Phosphate therapy was found to be of great benefit in lowering the urinary Ca when high after vitamin-D therapy. It seems likely that the beneficial effects of phosphate therapy observed by others in renal tubular aciodosis are due solely to a lowering of high urinary C. This effect of lowering urinary C is of no significant benefit when the urinary Ca is already low.