Evidence map›Paper›PMID 20631407›Full record

Trial reportNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2011

Pilot study of dietary phosphorus restriction and phosphorus binders to target fibroblast growth factor 23 in patients with chronic kidney disease.

Tamara Isakova, Orlando M Gutiérrez, Kelsey Smith, Michael Epstein, Leigh K Keating, Harald Jüppner, Myles Wolf

2 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 86 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 3 pooled it
10.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00438932 nacompletednot on this map

Reduced Phosphate Intake in "Normo-Phosphatemic" Chronic Kidney Disease Patients

TypeinterventionalSponsorMassachusetts General HospitalRan2007 to 2010Enrolled16ConditionsChronic Kidney DiseaseArmsLanthanum Carbonate, Low Phosphorus Diet, Unrestricted Phosphorus Diet, Placebo
NCT03367338 nacompletednot on this mapstarted 2018, after this paper: background citation

The Effect of Low-Phosphate Diet on Fibroblast Growth Factor-23 Level in Patients Undergoing Hemodialysis

TypeinterventionalSponsorWan-Chuan TsaiRan2018 to 2018Enrolled35ConditionsChronic Kidney Disease Requiring Chronic Dialysis, Hyperphosphatemia, Dietary Intervention, Elevated Fibroblast Growth Factor-23ArmsLow-phosphate diet
3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 3 syntheses or guidelines pooled it, 165 citations in OpenAlex.

  1. Pooled it
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  8. Randomized Clinical Trial of Sevelamer Carbonate on Serum Klotho and Fibroblast Growth Factor 23 in CKD.Clinical journal of the American Society of Nephrology : CJASN · 2017
    Trial
  9. Phosphorus Additives and Albuminuria in Early Stages of CKD: A Randomized Controlled Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2017
    Trial
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  15. Effects of dietary phosphate restriction and phosphate binders on FGF23 levels in CKD.Clinical journal of the American Society of Nephrology : CJASN · 2013
    Trial
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  17. Effects of phosphate binders in moderate CKD.Journal of the American Society of Nephrology : JASN · 2012
    Trial
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  19. Article
  20. Emerging concepts on the FGF23 regulation and activity.Molecular and cellular biochemistry · 2025
    Review

26 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Tamara IsakovaDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA. tisakova@med.miami.edu
Orlando M Gutiérrez
Kelsey Smith
Michael Epstein
Leigh K Keating
Harald Jüppner
Myles Wolf
University of Miami · USMassachusetts General Hospital · USMallinckrodt (United States) · US

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
ZD6416 Analgesic--Painful Distal Symmetrical PolyneuropaM01RR001066 · NCRR · MASSACHUSETTS GENERAL HOSPITAL · PI BROWN, EMERY N · 1985 to 2008
$37.4M
FGF23 and Cardiovascular Disease in CKDR01DK081374 · NIDDK · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI WOLF, MYLES S · 2008 to 2016
$4.2M
Role of FGF-23 in Mineral Metabolism Across the Spectum of Chronic Kidney DiseaseR01DK076116 · NIDDK · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI WOLF, MYLES S · 2007 to 2016
$2.9M
Calcium Handling and Secondary Hyperparathyroidism in Chronic Kidney DiseaseK23DK087858 · NIDDK · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI ISAKOVA, TAMARA · 2010 to 2014
$845k
Racial Differences in Phosphorus Metabolism in Health and in Kidney DiseaseK23DK081673 · NIDDK · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI GUTIERREZ, ORLANDO M · 2008 to 2012
$687k
NCRR NIH HHS M01 RR001066NCRR NIH HHS M01RR01066NCRR NIH HHS UL1 RR025758NCRR NIH HHS UL1RR025758-01NIDDK NIH HHS K23 DK081673NIDDK NIH HHS K23DK081673NIDDK NIH HHS K23 DK087858NIDDK NIH HHS R01 DK076116NIDDK NIH HHS R01DK076116NIDDK NIH HHS R01 DK081374NIDDK NIH HHS R01DK081374
6 · The paper itself

Abstract

backgroundHigh levels of fibroblast growth factor 23 (FGF23) are associated with mortality and progression of chronic kidney disease (CKD). Reducing dietary phosphorus intake lowers FGF23 secretion in healthly individuals, but there is little data on its effects in patients with pre-dialysis CKD.

methodsUsing a 2×2 factorial design, we randomly assigned 16 normophosphataemic CKD stage 3-4 patients to receive a 2-week treatment with either lanthanum carbonate 1000 mg three times daily or placebo, and to ingest a tightly controlled diet containing 750 or 1500 mg of dietary phosphorus daily. We analysed serial measurements of FGF23, parathyroid hormone, serum phosphate and calcium, and 24-h urinary phosphate and calcium excretion using repeated-measures analyses.

resultsCompared with the 1500-mg phosphorus diet, patients assigned to the 750-mg diet had greater reduction in 24-h urinary phosphate excretion (66% vs. 29%; P<0.0001). Lanthanum-treated patients experienced a significant reduction in 24-h urinary phosphate excretion compared with baseline (64%; P<0.0001), but the difference compared with placebo did not reach significance (64% vs. 31%). Despite the significant reductions in 24-h urinary phosphate excretion, no group demonstrated a significant reduction in FGF23 levels; FGF23 levels actually increased significantly in the 1500-mg diet plus placebo group, suggesting dietary phosphorus loading.

conclusionsAlthough dietary phosphorus restriction and lanthanum lowered urinary phosphate excretion consistent with a rapid decrease in phosphorus absorption, inducing a reduction in FGF23 levels in CKD patients may require interventions with a longer duration than in healthy volunteers.

Indexed as

AgedChelating AgentsFibroblast Growth Factor-23Fibroblast Growth FactorsHumansKidney Failure, ChronicLanthanumMiddle AgedPhosphorus CompoundsPhosphorus, DietaryPilot ProjectsChelating AgentsFGF23 protein, humanFibroblast Growth Factor-23Fibroblast Growth FactorsLanthanumlanthanum carbonatePhosphorus CompoundsPhosphorus, Dietary

Identifiers

PMID20631407
PMCPMC3108359
OpenAlexW2153481494

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.