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A cause of hypophosphatemia is phosphate wasting disorders. Knowledge concerning mechanisms involved in phosphate wasting disorders has greatly increased in the last decade by the identification of phosphatonins, among them FGF-23. FGF-23 is a primarily bone derived factor decreasing renal tubular reabsorption of phosphate and the synthesis of calcitriol. Currently, pharmacological treatment of these disorders offers limited efficacy and is potentially associated to gastrointestinal, renal, and parathyroid complications; therefore, efforts have been directed toward newer pharmacological strategies that target the FGF-23 pathway. This review focuses on phosphate metabolism, its main regulators, and phosphate wasting disorders in adults, highlighting the main issues related to diagnosis and current and new potential treatments.

Original publication

DOI

10.1007/s00198-018-4618-2

Type

Journal article

Journal

Osteoporos int

Publication Date

11/2018

Volume

29

Pages

2369 - 2387

Keywords

FGF-23, Hypophosphatemia, Osteomalacia, Phosphate wasting disorders, Rickets, Treatment, Fibroblast Growth Factors, Homeostasis, Humans, Hypophosphatemia, Intestinal Absorption, Kidney, Molecular Targeted Therapy, Osteomalacia, Phosphates