{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:42:56Z","timestamp":1786372976608,"version":"build-2736575974"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["F32 DK116476"],"award-info":[{"award-number":["F32 DK116476"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23 DK118197"],"award-info":[{"award-number":["K23 DK118197"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K24 DK110427"],"award-info":[{"award-number":["K24 DK110427"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["14EIA18560026"],"award-info":[{"award-number":["14EIA18560026"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["31O.041"],"award-info":[{"award-number":["31O.041"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Higher serum phosphate is associated with cardiovascular events and all-cause mortality. Explanations of this association have focused on large vessel calcification and stiffness. Studies suggest that a higher serum phosphate induces microvascular dysfunction, but relationships in humans with direct measures of microvascular function are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>We performed a cross-sectional analysis of 3189 community-living participants that underwent skin capillaroscopy, laser-Doppler flowmetry, and flicker light\u2013induced retinal vessel responses. We used linear regression to assess the association between serum phosphate and each microvascular outcome. The primary outcome was skin capillary recruitment during postocclusive peak reactive hyperemia by capillaroscopy. Secondary outcomes included capillary recruitment during venous congestion, heat-induced skin hyperemic response, flicker light\u2013induced retinal arteriolar, and venular dilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of the cohort was 59\u00b18 years, 48% were women, 7% had an eGFR &lt;60 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      , and the mean serum phosphate concentration was 3.2\u00b10.5 mg\/dl. A 1 mg\/dl higher serum phosphate was independently associated with a 5.0% lower postocclusive capillary recruitment (95% CI, \u221210.0% to \u22120.1%). Results were similar for capillary recruitment with venous congestion (\u22124.5%; 95% CI, \u22129.8% to 0.7%). A 1 mg\/dl higher serum phosphate was also independently associated with a 0.23% lower retinal venular dilation in response to flicker light (95% CI, \u22120.44% to \u22120.02%). A higher serum phosphate was not associated with change in flicker light\u2013induced retinal arteriolar dilation or heat-induced skin hyperemic response, however a higher serum phosphate was associated with a lower heat-induced skin hyperemic response among men (\u2212149% [95% CI, \u2212260 to \u221238] per 1 mg\/dl higher serum phosphate) but not women (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      interaction, 0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher serum phosphate concentrations, even within the normal range, are associated with microvascular dysfunction in community-living individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Podcast<\/jats:title>\n                    <jats:p>This article contains a podcast at https:\/\/www.asn-online.org\/media\/podcast\/CJASN\/2019_09_20_CJN02610319.mp3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.02610319","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T15:45:10Z","timestamp":1568994310000},"page":"1626-1633","source":"Crossref","is-referenced-by-count":37,"title":["Serum Phosphate and Microvascular Function in a Population-Based Cohort"],"prefix":"10.2215","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9408-3684","authenticated-orcid":false,"given":"Charles","family":"Ginsberg","sequence":"first","affiliation":[{"name":"Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California;"},{"name":"Division of Nephrology-Hypertension, University of California San Diego, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfons J.H.M.","family":"Houben","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and"},{"name":"CARIM School for Cardiovascular Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California;"},{"name":"Imperial Valley Family Care Medical Group, El Centro, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tos T.J.M.","family":"Berendschot","sequence":"additional","affiliation":[{"name":"University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter C.","family":"Dagnelie","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and"},{"name":"CARIM School for Cardiovascular Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen P.","family":"Kooman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and"},{"name":"NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroll A.","family":"Webers","sequence":"additional","affiliation":[{"name":"University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coen D.A.","family":"Stehouwer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and"},{"name":"CARIM School for Cardiovascular Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim H.","family":"Ix","sequence":"additional","affiliation":[{"name":"Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California;"},{"name":"Division of Nephrology-Hypertension, University of California San Diego, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,9,20]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1097\/01.ASN.0000133041.27682.A2","article-title":"Mineral metabolism, mortality, and morbidity in maintenance hemodialysis.","volume":"15","author":"Block","year":"2004","journal-title":"J Am Soc Nephrol"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"2885","DOI":"10.1093\/ndt\/gfq808","article-title":"Serum phosphorus predicts incident chronic kidney disease and end-stage renal disease.","volume":"26","author":"O\u2019Seaghdha","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1681\/ASN.2004070602","article-title":"Serum phosphate levels and mortality risk among people with chronic kidney 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