{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:09:32Z","timestamp":1793045372816,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002997","name":"Dutch Kidney Foundation","doi-asserted-by":"publisher","award":["19Okv018"],"award-info":[{"award-number":["19Okv018"]}],"id":[{"id":"10.13039\/501100002997","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,28]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with autosomal dominant polycystic kidney disease (ADPKD) have disproportionately high levels of fibroblast growth factor 23 (FGF-23) for their chronic kidney disease stage, however only a subgroup develops kidney phosphate wasting. We assessed factors associated with phosphate wasting and hypothesize that it identifies patients with more severe disease and predicts disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 604 patients with ADPKD from a multicenter prospective observational cohort (DIPAK; Developing Intervention Strategies to Halt Progression of Autosomal Dominant Polycystic Kidney Disease) in four university medical centers in the Netherlands. We measured parathyroid hormone (PTH) and total plasma FGF-23 levels, and calculated the ratio of tubular maximum reabsorption rate of phosphate to glomerular filtration rate (TmP\/GFR) with &amp;lt;0.8 mmol\/L defined as kidney phosphate wasting. We analysed the association of TmP\/GFR with estimated GFR (eGFR) decline over time and the risk for a composite kidney outcome (\u226530% eGFR decline, kidney failure or kidney replacement therapy).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In our cohort (age 48\u00a0\u00b1\u00a012 years, 39% male, eGFR 63\u00a0\u00b1\u00a028 mL\/min\/1.73 m2), 59% of patients had phosphate wasting. Male sex [coefficient \u20130.2, 95% confidence interval (CI) \u20130.2; \u20130.1], eGFR (0.002, 95% CI 0.001; 0.004), FGF-23 (0.1, 95% CI 0.03; 0.2), PTH (\u20130.2, 95% CI \u20130.3; \u20130.06) and copeptin (\u20130.08, 95% CI \u20130.1; \u20130.08) were associated with TmP\/GFR. Corrected for PTH, FGF-23 and eGFR, every 0.1 mmol\/L decrease in TmP\/GFR was associated with a greater eGFR decline of 0.2 mL\/min\/1.73 m2\/year (95% CI 0.01; 0.3) and an increased hazard ratio of 1.09 (95% CI 1.01; 1.18) of the composite kidney outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study shows that in patients with ADPKD, phosphate wasting is prevalent and associated with more rapid disease progression. Phosphate wasting may be a consequence of early proximal tubular dysfunction and insufficient suppression of PTH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfad247","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T10:22:09Z","timestamp":1700130129000},"page":"1105-1114","source":"Crossref","is-referenced-by-count":8,"title":["Kidney phosphate wasting predicts poor outcome in polycystic kidney disease"],"prefix":"10.1093","volume":"39","author":[{"given":"Laixi","family":"Xue","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Geurts","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Meijer","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Medical Center Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-8733","authenticated-orcid":false,"given":"Martin H","family":"de Borst","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Medical Center Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3223-0906","authenticated-orcid":false,"given":"Ron T","family":"Gansevoort","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Medical Center Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Zietse","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8738-3571","authenticated-orcid":false,"given":"Ewout J","family":"Hoorn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4568-8967","authenticated-orcid":false,"given":"Mahdi","family":"Salih","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the DIPAK Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost P H","family":"Drenth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes W","family":"de Fijter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Losekoot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorien J M","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack 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