The effects of elevated phosphate on the kidney - damaging the gatekeeper

The kidney is a major regulator of phosphate metabolism. The body can lower systemic phosphate levels by increasing renal phosphate excretion, and kidney injury results in elevated serum phosphate concentrations (hyperphosphatemia). Chronic kidney disease (CKD) is associated with various organ injuries, including vascular calcification and cardiovascular disease, where hyperphosphatemia acts as a pathologic driver. Here we discuss hyperphosphatemia not as a consequence of kidney disease but as a