ArticleAnnals of surgery2009
Mechanisms of renal phosphate loss in liver resection-associated hypophosphatemia.
Article in Annals of surgery, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Systematic review of pathophysiological changes following hepatic resection.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2014Pooled it
- Soft tissue calcifications in chronic kidney disease-beyond the vasculature.Pflugers Archiv : European journal of physiology · 2025Review
- Development, Design and Utilization of a CDSS for Refeeding Syndrome in Real Life Inpatient Care-A Feasibility Study.Nutrients · 2023Article
- Hypophosphatemia as a prognostic tool for post-hepatectomy liver failure: A systematic review.World journal of gastrointestinal surgery · 2023Article
- Approach to Hypophosphatemic Rickets.The Journal of clinical endocrinology and metabolism · 2022Article
- Outcomes of patients with post-hepatectomy hypophosphatemia: A narrative review.World journal of hepatology · 2022Review
- Hypophosphatemia in acute liver failure of a broad range of etiologies is associated with phosphaturia without kidney damage or phosphatonin elevation.Translational research : the journal of laboratory and clinical medicine · 2021Article
- New Therapies for Hypophosphatemia-Related to FGF23 Excess.Calcified tissue international · 2021Review
- Hypophosphatemia as a Predictor of Organ-Specific Complications Following Gastrointestinal Surgery: Analysis of 8034 Patients.World journal of surgery · 2019Article
- NAD metabolism and the SLC34 family: evidence for a liver-kidney axis regulating inorganic phosphate.Pflugers Archiv : European journal of physiology · 2019Review
- Impact of Perioperative Phosphorus and Glucose Levels on Liver Regeneration and Long-term Outcomes after Major Liver Resection.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2016Article
- Regulation of renal phosphate handling: inter-organ communication in health and disease.Journal of bone and mineral metabolism · 2016Review
- Hypophosphataemia after major hepatectomy and the risk of post-operative hepatic insufficiency and mortality: an analysis of 719 patients.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2014Article
- Hepatectomy-related hypophosphatemia: a novel phosphaturic factor in the liver-kidney axis.Journal of the American Society of Nephrology : JASN · 2014Article
- Operative terminology and post-operative management approaches applied to hepatic surgery: Trainee perspectives.World journal of gastrointestinal surgery · 2013Article
- Approach to the hypophosphatemic patient.The Journal of clinical endocrinology and metabolism · 2012Article
- Parenteral nutrition in liver resection.Journal of nutrition and metabolism · 2012Article
- FGF23 and syndromes of abnormal renal phosphate handling.Advances in experimental medicine and biology · 2012Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo determine precisely the role of parathyroid hormone (PTH) and of phosphatonins in the genesis of posthepatectomy hypophosphatemia.
backgroundPosthepatectomy hypophosphatemia has recently been related to increased renal fractional excretion of phosphate (FE P). To address the cause of hypophosphatemia, we measured serum concentrations of PTH, various phosphatonins, and the number of removed hepatic segment in patients with this disorder.
methodsSerum phosphate (PO4), ionized calcium (Ca++), HCO3-, pH and FE P, intact PTH (I-PTH), carboxyl-terminal fibroblast growth factor 23 (C-FGF-23) and intact fibroblast growth factor 23 (I-FGF-23), FGF-7, and secreted frizzled related-protein-4 (sFRP-4) were measured before and on postoperative (po) days 1, 2, 3, 5, and 7, in 18 patients undergoing liver resection. The number of removed hepatic segments was also assessed.
resultsSerum PO4 concentrations decreased within 24 hours, were lowest (0.66 +/- 0.03 mmol/L; P < 0.001) at 48 hours, and returned to normal within 5 days of the procedure. FE P peaked at 25.07% +/- 2.26% on po day 1 (P < 0.05). Decreased ionized calcium concentrations (1.10 +/- 0.01 mmol/L; P < 0.01) were observed on po day 1 and were negatively correlated with increased I-PTH concentrations (8.8 +/- 0.9 pmol/L; P < 0.01; correlation: r = -0.062, P = 0.016). FE P was positively related to I-PTH levels on po day 1 (r = 0.52, P = 0.047) and negatively related to PO4 concentrations (r = -0.56, P = 0.024). Severe hypophosphatemia and increased urinary phosphate excretion persisted for 72 hours even when I-PTH concentrations had returned to normal. I-FGF-23 decreased to its nadir of 7.8 +/- 6.9 pg/mL (P < 0.001) on po day 3 and was correlated with PO4 levels on po days 0, 3, 5, and 7 (P < 0.001). C-FGF-23, FGF-7 and sFRP-4 levels could not be related to either PO4 concentrations or FE P.
conclusionPosthepatectomy hypophosphatemia is associated with increased FE P unrelated to I-FGF-23 or C-FGF-23, FGF-7, or sFRP-4. I-PTH contributes to excessive FE P partially on po day 1 but not thereafter. Other yet defined factors should explain post hepatectomy hypophosphatemia.
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