ReviewPediatric nephrology (Berlin, Germany)2013
Phosphate is a vascular toxin.
Review in Pediatric nephrology (Berlin, Germany), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.
- The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis-clinical practice recommendation from the Pediatric Renal Nutrition Taskforce.Pediatric nephrology (Berlin, Germany) · 2020Guideline
- Effect of renin-angiotensin system blockade on soluble Klotho in patients with type 2 diabetes, systolic hypertension, and albuminuria.Clinical journal of the American Society of Nephrology : CJASN · 2013Trial
- The role of oral sodium bicarbonate supplementation in maintaining acid-base balance and its influence on the cardiovascular system in chronic hemodialysis patients - results of a prospective study.Journal of medicine and lifeTrial
- Approach to a Child with Hypophosphatemia.Biomolecules · 2025Review
- Enzymatic Hydrolysis of Salmon Frame Proteins Using a Sequential Batch Operational Strategy: An Improvement in Water-Holding Capacity.Foods (Basel, Switzerland) · 2024Article
- Effect of Adding Bovine Skin Gelatin Hydrolysates on Antioxidant Properties, Texture, and Color in Chicken Meat Processing.Foods (Basel, Switzerland) · 2023Article
- VEGFR2 insufficiency enhances phosphotoxicity and undermines Klotho's protection against peritubular capillary rarefaction and kidney fibrosis.American journal of physiology. Renal physiology · 2023Article
- Rapamycin downregulates α-klotho in the kidneys of female rats with normal and reduced renal function.PloS one · 2023Article
- Hyperparathyroidism Is an Independent Risk Factor for Allograft Dysfunction in Pediatric Kidney Transplantation.Kidney international reports · 2023Article
- Phosphate Is a Cardiovascular Toxin.Advances in experimental medicine and biology · 2022Review
- Contribution of Gut Microbiota-Derived Uremic Toxins to the Cardiovascular System Mineralization.Toxins · 2021Review
- Hyperphosphatemia and Chronic Kidney Disease: A Major Daily Concern Both in Adults and in Children.Calcified tissue international · 2021Review
- Intermittent Bi-Daily Sub-cutaneous Teriparatide Administration in Children With Hypoparathyroidism: A Single-Center Experience.Frontiers in pediatrics · 2021Article
- Treatment of hyperphosphatemia: the dangers of aiming for normal PTH levels.Pediatric nephrology (Berlin, Germany) · 2020Article
- Matrix metalloproteinase -2, -9 and arterial stiffness in children and adolescents: The role of chronic kidney disease, diabetes, and hypertension.International Journal of Cardiology. Hypertension · 2020Article
- Treatment of hyperphosphatemia: the dangers of high PTH levels.Pediatric nephrology (Berlin, Germany) · 2020Review
- Vascular Calcification: An Important Understanding in Nephrology.Vascular health and risk management · 2020Review
- The relation between serum phosphorus levels and long-term mortality in Chinese patients with ST-segment elevation myocardial infarction.Journal of geriatric cardiology : JGC · 2019Article
- Drug-metabolizing enzymes CYP3A as a link between tacrolimus and vitamin D in renal transplant recipients: is it relevant in clinical practice?Pediatric nephrology (Berlin, Germany) · 2019Review
- Signaling pathways involved in vascular smooth muscle cell calcification during hyperphosphatemia.Cellular and molecular life sciences : CMLS · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Elevated phosphate (P) levels are seen in advanced renal failure and, together with dysregulated calcium, parathyroid hormone and vitamin D levels, contribute to the complex of chronic kidney disease-mineral and bone disease (CKD-MBD). Converging evidence from in vitro, clinical and epidemiological studies suggest that increased P is associated with vascular calcification and mortality. When vessels are exposed to high P conditions in vitro, they develop apoptosis, convert to bone-like cells and develop extensive calcification. Clinical studies in children on dialysis show that high P is associated with increased vessel wall thickness, arterial stiffness and coronary calcification. Epidemiological studies in adult dialysis patients demonstrate a significant and independent association between raised P and mortality. Importantly, raised P is associated with cardiovascular changes even in pre-dialysis CKD, and also in subjects with normal renal function but high P. All P binders can effectively reduce serum P, and this decrease is linked to improved survival. Raised serum P triggers the release of fibroblast growth factor 23 (FGF-23), which has the beneficial effect of increasing P excretion in early CKD, but is increased several 1,000-fold in dialysis, and may be an independent cardiovascular risk factor. Both FGF-23 and its co-receptor Klotho may have direct effects on the vasculature leading to calcification. Fascinatingly, disturbances in FGF-23-Klotho and raised P have also been associated with premature aging. These data suggest that high P levels have adverse vascular effects and that maintaining the serum P levels in the normal range reduces cardiovascular risk and mortality.
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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.