Evidence for a bone-kidney axis regulating phosphate homeostasis

J Clin Invest. 2003 Sep;112(5):642-6. doi: 10.1172/JCI19687.


A novel circulation phosphaturic hormone is postulated to regulate systemic phosphate homeostasis. Two new studies reveal that the phosphaturic factor FGF-23 is increased in hypophosphatemic subjects with McCune-Albright syndrome and that secreted frizzled-related protein-4 (sFRP-4), a factor produced by tumors derived from subjects with tumor-induced osteomalacia, also has phosphaturic activity. It remains to be established whether FGF-23 and sFRP-4 represent two distinct phosphatonins or are somehow integrated in a novel phosphate-regulating bone-kidney axis.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Comment

MeSH terms

  • Animals
  • Bone and Bones / metabolism*
  • Calcification, Physiologic
  • Extracellular Matrix Proteins*
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / physiology
  • Glycoproteins / physiology
  • Homeostasis*
  • Humans
  • Kidney / metabolism*
  • Mice
  • Phosphates / metabolism*
  • Phosphoproteins / physiology
  • Proto-Oncogene Proteins / physiology


  • Extracellular Matrix Proteins
  • Glycoproteins
  • MEPE protein, human
  • Phosphates
  • Phosphoproteins
  • Proto-Oncogene Proteins
  • SFRP4 protein, human
  • Sfrp4 protein, mouse
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23