Rickets - A case report.

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Abstract

Conflict of interest statement: There are no conflicts of interest. 11. Osteoporos Int. 2018 Nov;29(11):2369-2387. doi: 10.1007/s00198-018-4618-2. Epub 2018 Jul 16. Phosphate wasting disorders in adults. Marcucci G(1), Masi L(1), Ferrarì S(2), Haffner D(3), Javaid MK(4), Kamenický P(5), Reginster JY(6), Rizzoli R(2), Brandi ML(7). Author information: (1)Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. (2)Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. (3)Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany. (4)Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. (5)Service d'Endocrinologie et des Maladies de la Reproduction, Centre de référence des Maladies Rares du métabolisme du calcium et du phosphore, Hopital de Bicêtre - AP-HP, 94275, Le Kremlin-Bicêtre, France. (6)Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. (7)Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. marialuisa.brandi@unifi.it. A cause of hypophosphatemia is phosphate wasting disorders. Knowledge concerning mechanisms involved in phosphate wasting disorders has greatly increased in the last decade by the identification of phosphatonins, among them FGF-23. FGF-23 is a primarily bone derived factor decreasing renal tubular reabsorption of phosphate and the synthesis of calcitriol. Currently, pharmacological treatment of these disorders offers limited efficacy and is potentially associated to gastrointestinal, renal, and parathyroid complications; therefore, efforts have been directed toward newer pharmacological strategies that target the FGF-23 pathway. This review focuses on phosphate metabolism, its main regulators, and phosphate wasting disorders in adults, highlighting the main issues related to diagnosis and current and new potential treatments. DOI: 10.1007/s00198-018-4618-2