{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:51:08Z","timestamp":1791273068781,"version":"4.1.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015883","name":"Sociedad Espa\u00f1ola de Nefrolog\u00eda","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015883","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["RD24\/0004\/0022"],"award-info":[{"award-number":["RD24\/0004\/0022"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypophosphatemia is a frequent electrolyte abnormality after chimeric antigen receptor T-cell (CAR-T) therapy, but the clinical and biological factors associated with phosphate decline remain poorly defined. We prospectively evaluated the incidence, determinants, and potential biological associations of hypophosphatemia after CAR-T therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective study including 63 adults with B-cell lymphoma treated with CAR-T therapy between June 2020 and December 2023. Serum phosphate was measured daily during hospitalization. First-morning urine and blood samples were obtained at infusion (D0) and on days +7 (D7) and +14 (D14). Fractional excretion of phosphate (FEPO\u2084), urine protein-to-creatinine ratio (uPCR), parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23) were assessed. Patients were stratified according to the presence of moderate hypophosphatemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hypophosphatemia occurred in 49\/63 patients (78%), including 26 (41%) with moderate hypophosphatemia. Median time to phosphate nadir was 6 days. Patients with moderate hypophosphatemia had higher baseline lactate dehydrogenase levels and Endothelial Activation and Stress Index scores, lower phosphate and creatinine levels at infusion, and a higher frequency of prior ifosfamide exposure. Higher uPCR at D7, higher peak interleukin-6 levels and higher FEPO\u2084 at D7 were associated with lower phosphate nadir values (\u03c1 = \u22120.55, P\u00a0&amp;lt;\u00a0.001; \u03c1 = \u22120.55, P\u00a0&amp;lt;\u00a0.001; and \u03c1 = \u22120.31, P\u00a0=\u00a0.018, respectively). FGF23 levels were not associated with hypophosphatemia in the primary analysis, while PTH showed a modest inverse association with phosphate nadir in exploratory analysis. Moderate hypophosphatemia was associated with inferior overall survival in univariable analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hypophosphatemia is common after CAR-T therapy and was associated with systemic inflammation, urinary markers compatible with partial proximal tubular dysfunction and altered renal phosphate handling. Secondary hyperparathyroidism may have contributed in a subset of patients, whereas FGF23 did not appear to be a dominant explanatory pathway in this cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag307","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:01:28Z","timestamp":1788440488000},"source":"Crossref","is-referenced-by-count":0,"title":["Hypophosphatemia after CAR-T cell therapy: a prospective study of inflammation, tubular injury and phosphate handling"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1812-4098","authenticated-orcid":false,"given":"Francesc","family":"Moncho-Franc\u00e9s","sequence":"first","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Nephrology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Hernani","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Hematology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel","family":"Solis-Salguero","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Nephrology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Benzaqu\u00e9n","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Hematology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Juan-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Nephrology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"P\u00e9rez-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Hematology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Mic\u00f3","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Hematology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5015-7474","authenticated-orcid":false,"given":"Juan F","family":"Navarro-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Nuestra Se\u00f1ora de Candelaria Research Unit and Nephrology Department, , Santa Cruz de Tenerife ,","place":["Spain"]},{"name":"Institute of Biomedical Technologies, Universidad de La Laguna, La Laguna , Santa Cruz de Tenerife ,","place":["Spain"]},{"name":"Faculty of Health Sciences, Universidad Fernando Pessoa Canarias , Las Palmas de Gran Canaria ,","place":["Spain"]},{"name":"RICORS2040-RENAL (RD24\/0004\/0022), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8533-2562","authenticated-orcid":false,"given":"Jose Luis","family":"Pi\u00f1ana","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Hematology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Hern\u00e1ndez\u00a0Boluda","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Hematology Department, , Valencia ,","place":["Spain"]},{"name":"Universitat de Val\u00e8ncia Department of Medicine, Faculty of Medicine, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jose","family":"Terol","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Hematology Department, , Valencia ,","place":["Spain"]},{"name":"Universitat de Val\u00e8ncia Department of Medicine, Faculty of Medicine, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Solano","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Hematology Department, , Valencia ,","place":["Spain"]},{"name":"Universitat de Val\u00e8ncia Department of Medicine, Faculty of Medicine, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1134-9051","authenticated-orcid":false,"given":"Jose Luis","family":"G\u00f3rriz","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Nephrology Department, , Valencia ,","place":["Spain"]},{"name":"RICORS2040-RENAL (RD24\/0004\/0022), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]},{"name":"Universitat de Val\u00e8ncia Department of Medicine, Faculty of Medicine, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isidro","family":"Torregrosa","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia, INCLIVA Biomedical Research Institute Nephrology Department, , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"2026100602562153600_bib1","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1038\/s41571-023-00754-1","article-title":"Long-term outcomes following CAR T cell therapy: what we know so far","volume":"20","author":"Cappell","year":"2023","journal-title":"Nat Rev Clin Oncol"},{"key":"2026100602562153600_bib2","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1016\/S0140-6736(23)01126-1","article-title":"CAR T-cell therapy in autoimmune 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