Renal Handling of Phosphate in Relation to Serum Parathyroid Hormone Levels

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Abstract
The relation between the renal handling of phosphate, expressed as the maximal tubular reabsorption of phosphate (TmP)/glomerular filtration rate (GFR) index, and the serum concentration of immunoreactive parathyroid hormone (i-PTH) was investigated in 15 patients with a very wide range of GFR, TmP/GFR and i-PTH. Seven patients had well functioning kidney allografts, with GFR ranging from 43.1-64.9 ml/min, while 8 had varying degrees of chronic nephropathy, with GFR ranging from 26.7-2.3 ml/min. The TmP, the i-PTH concentration, the 51Cr EDTA clearance, the extracellular volume and the serum concentrations of Ca and standard bicarbonate were estimated during conditions where tubular reabsorption of phosphate was maximal. An inverse significant correlation was demonstrated between TmP/GFR and i-PTH (P < 0.001), while none of the other investigated factors correlated to to the TmP/GFR index. The parathyroid hormone has a key role in the regulation of the tubular handling of phosphate in patients with impaired renal function.