MOE: Phosphorus or Phosphate
👉 PROXIMAL Tubule: Main site for regulation of phosphate (some is reabsorbed with Na and H20; most is regulated by change in FGF23)
👉 DISTAL Tubule: Main site for regulation of calcium and potassium
#NKFClinicals #Nephpearls #CKDMBD
Phosphorus bioavailability "varies" by source
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Active Intestinal Phosphate Transport and Passive Intestinal Phosphate (Paracellular) Transport
📌 Note that in these tight junctions, there are 5 groups of proteins that regulate this: occludens, claudins, JAMA, E-cadherin, desmosomes
#NKFClinicals #Nephpearls
.@gchertow Hyperphosphatemia is bad
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WOLFE: Sources and "bioavailability" of dietary phosphate
#NKFClinicals #Nephpearls
WOLFE: Tenapanor (NHE3 inhibitor) causes an "intracellular acidemia" which leads to clamping down of the intracellular tight junction between 2 adjacent enterocytes so that phosphate is unable to readily pass paracellularly
PRO: BID dosing only; ⬇️FGF23
#NKFClinicals #Nephpearls
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