Hyperphosphatemia of chronic kidney disease

Kidney Int. 2008 Jul;74(2):148-57. doi: 10.1038/ki.2008.130. Epub 2008 Apr 30.


Observational studies have determined hyperphosphatemia to be a cardiovascular risk factor in chronic kidney disease. Mechanistic studies have elucidated that hyperphosphatemia is a direct stimulus to vascular calcification, which is one cause of morbid cardiovascular events contributing to the excess mortality of chronic kidney disease. This review describes the pathobiology of hyperphosphatemia that develops as a consequence of positive phosphate balance in chronic kidney disease and the mechanisms by which hyperphosphatemia acts on neointimal vascular cells that are stimulated to mineralize in chronic kidney disease. The characterization of hyperphosphatemia of chronic kidney disease as a distinct syndrome in clinical medicine with unique disordered skeletal remodeling, heterotopic mineralization and cardiovascular morbidity is presented.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Calcinosis / etiology*
  • Calcinosis / metabolism
  • Calcinosis / mortality
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / mortality
  • Chronic Disease
  • Chronic Kidney Disease-Mineral and Bone Disorder / etiology
  • Chronic Kidney Disease-Mineral and Bone Disorder / metabolism
  • Humans
  • Hyperphosphatemia / complications
  • Hyperphosphatemia / metabolism*
  • Hyperphosphatemia / mortality
  • Kidney Diseases / complications
  • Kidney Diseases / metabolism*
  • Kidney Diseases / mortality
  • Osteoporosis / etiology
  • Osteoporosis / metabolism
  • Phosphates / metabolism
  • Syndrome


  • Phosphates