{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T20:00:15Z","timestamp":1786132815044,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","funder":[{"DOI":"10.13039\/501100006451","name":"Hospices Civils de Lyon","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006451","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"published-print":{"date-parts":[[2021,1]]},"abstract":"\n Significance Statement<\/jats:title>\n \n The origin of most of the phosphate removed during hemodialysis has been uncertain. In this pilot study, the authors used phosphorus (\n 31<\/jats:sup>\n P) magnetic resonance spectroscopy to quantify intracellular inorganic phosphate (Pi), phosphocreatine, and ATP kinetics in 11 patients with ESKD during a 4-hour hemodialysis treatment. They found a decreased concentration of both intracellular Pi and ATP, confirming that Pi is, at least partially, released by the intracellular compartment. This finding raises the possibility that excessive dialytic removal of phosphate might adversely affect the intracellular availability of high-energy phosphates and ultimately, cellular metabolism.\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n The precise origin of phosphate that is removed during hemodialysis remains unclear; only a minority comes from the extracellular space. One possibility is that the remaining phosphate originates from the intracellular compartment, but there have been no available data from direct assessment of intracellular phosphate in patients undergoing hemodialysis.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We used phosphorus magnetic resonance spectroscopy to quantify intracellular inorganic phosphate (Pi), phosphocreatine (PCr), and\n \u03b2<\/jats:italic>\n ATP. In our pilot, single-center, prospective study, 11 patients with ESKD underwent phosphorus (\n 31<\/jats:sup>\n P) magnetic resonance spectroscopy examination during a 4-hour hemodialysis treatment. Spectra were acquired every 152 seconds during the hemodialysis session. The primary outcome was a change in the PCr-Pi ratio during the session.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During the first hour of hemodialysis, mean phosphatemia decreased significantly (\u221241%;\n P<\/jats:italic>\n <0.001); thereafter, it decreased more slowly until the end of the session. We found a significant increase in the PCr-Pi ratio (+23%;\n P<\/jats:italic>\n =0.001) during dialysis, indicating a reduction in intracellular Pi concentration. The PCr-\n \u03b2<\/jats:italic>\n ATP ratio increased significantly (+31%;\n P<\/jats:italic>\n =0.001) over a similar time period, indicating a reduction in\n \u03b2<\/jats:italic>\n ATP. The change of the PCr-\n \u03b2<\/jats:italic>\n ATP ratio was significantly correlated to the change of depurated Pi.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Phosphorus magnetic resonance spectroscopy examination of patients with ESKD during hemodialysis treatment confirmed that depurated Pi originates from the intracellular compartment. This finding raises the possibility that excessive dialytic depuration of phosphate might adversely affect the intracellular availability of high-energy phosphates and ultimately, cellular metabolism. Further studies are needed to investigate the relationship between objective and subjective effects of hemodialysis and decreases of intracellular Pi and\n \u03b2<\/jats:italic>\n ATP content.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial registry name and registration number<\/jats:title>\n Intracellular Phosphate Concentration Evolution During Hemodialysis by MR Spectroscopy (CIPHEMO), NCT03119818<\/jats:p>\n <\/jats:sec>","DOI":"10.1681\/asn.2020050716","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T21:45:16Z","timestamp":1603403116000},"page":"229-237","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":30,"title":["Intracellular Phosphate and ATP Depletion Measured by Magnetic Resonance Spectroscopy in Patients Receiving Maintenance Hemodialysis"],"prefix":"10.1681","volume":"32","clinical-trial-number":[{"clinical-trial-number":"nct03119818","registry":"10.18810\/clinical-trials-gov","type":"results"},{"clinical-trial-number":"nct03119818","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Guillaume","family":"Chazot","sequence":"first","affiliation":[{"name":"Service de n\u00e9phrologie et d\u2019exploration fonctionnelle r\u00e9nale, H\u00f4pital Edouard Herriot, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Lemoine","sequence":"additional","affiliation":[{"name":"Service de n\u00e9phrologie et d\u2019exploration fonctionnelle r\u00e9nale, H\u00f4pital Edouard Herriot, Hospices Civils de Lyon, Lyon, France"},{"name":"CARMEN U1060 Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (Cardiovascular Metabolisme Nutrition), Universit\u00e9 de Lyon, Universit\u00e9 Claude Bernard, INSA de Lyon, Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Kocevar","sequence":"additional","affiliation":[{"name":"CREATIS (Centre de Recherche et d'Applications en Traitement de l'Image et du Signal) Unit\u00e9 Mixte de Recherche 5220 Centre National de la Recherche Scientifique and U1206 Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Universit\u00e9 de Lyon, Universit\u00e9 Claude Bernard, INSA (Institut National Des Sciences Appliqu\u00e9es) de Lyon, Villeurbanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Kalbacher","sequence":"additional","affiliation":[{"name":"Service de n\u00e9phrologie et d\u2019exploration fonctionnelle r\u00e9nale, H\u00f4pital Edouard Herriot, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Sappey-Marinier","sequence":"additional","affiliation":[{"name":"CREATIS (Centre de Recherche et d'Applications en Traitement de l'Image et du Signal) Unit\u00e9 Mixte de Recherche 5220 Centre National de la Recherche Scientifique and U1206 Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Universit\u00e9 de Lyon, Universit\u00e9 Claude Bernard, INSA (Institut National Des Sciences Appliqu\u00e9es) de Lyon, Villeurbanne, France"},{"name":"CERMEP-Imagerie du vivant (Centre d'Etude et de Recherche M\u00e9dicale par Emission de Positons), Universit\u00e9 de Lyon, Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Rouvi\u00e8re","sequence":"additional","affiliation":[{"name":"Service de radiologie, H\u00f4pital \u00c9douard-Herriot, Hospices Civils de Lyon, Lyon, France"},{"name":"Labtau U1032 Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Universit\u00e9 de Lyon, Universit\u00e9 Claude Bernard, Villeurbanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Juillard","sequence":"additional","affiliation":[{"name":"Service de n\u00e9phrologie et d\u2019exploration fonctionnelle r\u00e9nale, H\u00f4pital Edouard Herriot, Hospices Civils de Lyon, Lyon, France"},{"name":"CARMEN U1060 Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (Cardiovascular Metabolisme Nutrition), Universit\u00e9 de Lyon, Universit\u00e9 Claude Bernard, INSA de Lyon, Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10,22]]},"reference":[{"key":"B1-20240826","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1053\/ajkd.1998.v31.pm9531176","article-title":"Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: A national study","volume":"31","author":"Block","year":"1998","journal-title":"Am J Kidney 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