Study of the Impact of Phosphate Supplementation on FGF23 Concentrations in Patients With Hypophosphatemia (PHOSPHO-23)
Fibroblast growth factor 23 (FGF23) is the principal hormone regulating serum phosphate homeostasis. Secreted by osteocytes, it promotes renal phosphate excretion and suppresses the synthesis of 1,25-dihydroxyvitamin D. Measurement of FGF23 has become a key tool in the evaluation of hypophosphatemia, allowing distinction between FGF23-dependent forms (such as X-linked hypophosphatemic rickets, tumor-induced osteomalacia, and intravenous iron-induced hypophosphatemia) and FGF23-independent forms (including renal, gastrointestinal, nutritional, or drug-related causes).
In healthy adults, several studies have demonstrated that FGF23 levels vary according to phosphate intake, decreasing during dietary restriction and increasing following phosphate loading. In hypophosphatemic conditions, however, available data are limited to X-linked hypophosphatemic rickets, where prolonged supplementation with phosphate and calcitriol leads to increased FGF23 levels, consistent with the underlying pathophysiology.
Based on these observations, it is currently recommended, as a precaution, to measure FGF23 at least 15 days after discontinuation of phosphate supplementation in order to avoid transient elevations that may confound interpretation. In practice, however, this recommendation is difficult to implement, as most patients are already receiving phosphate supplementation at the time of evaluation.
To date, no study has specifically assessed the effect of phosphate supplementation in patients with FGF23-independent hypophosphatemia, a condition characterized by appropriately low FGF23 levels. It therefore remains unclear whether supplementation could induce a transient rise in circulating FGF23, potentially leading to misclassification as FGF23-dependent hypophosphatemia (FGF23 > 95 ng/L).
This uncertainty provides a strong rationale for conducting the present study.
研究概览
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名：Lise Laclautre
- 电话号码：0473754963
- 邮箱：promo_interne_drci@chu-clermontferrand.fr
学习地点
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Clermont-Ferrand、法国
- 招聘中
- CHU Clermont-Ferrand Service de réanimation
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接触：
- Lise Laclautre
- 电话号码：0473754963
- 邮箱：promo_interne_drci@chu-clermontferrand.fr
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首席研究员：
- Laurent RENARD-TRICHE
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Clermont-Ferrand、法国
- 招聘中
- CHU Clermont-Ferrand Service Oncologie
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首席研究员：
- Aurore DOUGE
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接触：
- Lise Laclautre
- 电话号码：0473754963
- 邮箱：promo_interne_drci@chu-clermontferrand.fr
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Clermont-Ferrand、法国
- 招聘中
- CHU Clermont-Ferrand Service Rhumatologie
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接触：
- Lise Laclautre
- 电话号码：0473754963
- 邮箱：promo_interne_drci@chu-clermontferrand.fr
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首席研究员：
- Marie PICKERING
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria:
- Patients hospitalized in adult intensive care, oncology, or rheumatology
- Hypophosphatemia < 0.8 mmol/L
- Clinical indication for phosphate supplementation
Exclusion Criteria:
- Chronic kidney disease, stage ≥ 3 (eGFR < 60 mL/min/1.73 m²)
- Treatment with Ferinject® within the past year
- Sepsis
- Current treatment with active vitamin D
- Pregnancy or breastfeeding
- Inability to perform blood draws due to insufficient venous access
- Weight < 35 kg (for intensive care patients only)
- Hypercalcemia > 2.6 mmol/L
学习计划
研究是如何设计的？
设计细节
- 主要用途：其他
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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其他：Patients hospitalized in adult intensive care, oncology, or rheumatology
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Collection of one EDTA tube for FGF23 measurement and one heparin tube for phosphorus measurement
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Impact of phosphate supplementation on plasma FGF23 levels in acquired FGF23-independent hypophosphatemia
大体时间：Up to 21 days
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To determine whether phosphate supplementation modifies plasma FGF23 concentrations in patients with acquired FGF23-independent hypophosphatemia by studying changes in FGF23 concentrations following phosphate supplementation. The primary objective will be studied separately in two groups: first, in intensive care patients, and second, in oncology/rheumatology patients. |
Up to 21 days
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合作者和调查者
调查人员
- 学习椅：Damien BOUVIER、CHU Clermont-Ferrand service de biochimie
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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