Ugrica Marko, Bettoni Carla, Bourgeois Soline, Daryadel Arezoo, Pastor-Arroyo Eva-Maria, Gehring Nicole, Hernando Nati, Wagner Carsten A, Rubio-Aliaga Isabel
Institute of Physiology, University of Zurich, and National Center of Competence in Research NCCR Kidney.CH, Zurich, Switzerland.
Nephrol Dial Transplant. 2021 Jan 30. doi: 10.1093/ndt/gfab015.
Phosphate intake has increased in the last decades due to a higher consumption of processed foods. This higher intake is detrimental for patients with chronic kidney disease, increasing mortality and cardiovascular disease risk and accelerating kidney dysfunction. Whether a chronic high phosphate diet is also detrimental for the healthy population is still under debate.
We fed healthy mature adult mice over a period of one year with either a high (1.2% w/w) or a standard (0.6% w/w) phosphate diet, and investigated the impact of a high phosphate diet on mineral homeostasis, kidney function and bone health.
The high phosphate diet increased plasma phosphate, parathyroid hormone (PTH) and calcitriol levels, with no change in fibroblast growth factor 23 levels. Urinary phosphate, calcium and ammonium excretion were increased. Measured glomerular filtration rate was apparently unaffected, while blood urea was lower and urea clearance was higher in animals fed the high phosphate diet. No change was observed in plasma creatinine levels. Blood and urinary pH were more acidic paralleled by higher bone resorption observed in animals fed a high phosphate diet. Total and cortical bone mineral density was lower in animals fed a high phosphate diet and this effect is independent of the higher PTH levels observed.
A chronic high phosphate intake did not cause major renal alterations, but affected negatively bone health, increasing bone resorption and decreasing bone mineral density.
在过去几十年中，由于加工食品消费量增加，磷的摄入量有所上升。这种较高的摄入量对慢性肾脏病患者有害，会增加死亡率和心血管疾病风险，并加速肾功能障碍。长期高磷饮食对健康人群是否也有害仍存在争议。
我们用高磷饮食（1.2% 重量/重量）或标准磷饮食（0.6% 重量/重量）喂养健康的成年小鼠一年，并研究高磷饮食对矿物质稳态、肾功能和骨骼健康的影响。
高磷饮食使血浆磷、甲状旁腺激素（PTH）和骨化三醇水平升高，成纤维细胞生长因子23水平无变化。尿磷、钙和铵排泄增加。测量的肾小球滤过率明显未受影响，而高磷饮食喂养的动物血尿素较低，尿素清除率较高。血浆肌酐水平未见变化。高磷饮食喂养的动物血液和尿液pH值更偏酸性，同时观察到更高的骨吸收。高磷饮食喂养的动物总骨密度和皮质骨密度较低，且这种影响与观察到的较高PTH水平无关。
长期高磷摄入不会引起主要的肾脏改变，但会对骨骼健康产生负面影响，增加骨吸收并降低骨密度。
