Effect of nutritional calcium and phosphate loading on calciprotein particle kinetics in adults with normal and impaired kidney function
Open accessAbstract
Plasma approaches metastability with respect to its calcium and phosphate content, with only minor perturbations in ionic activity needed to sustain crystal growth once nucleated. Physiologically, calcium and phosphate are intermittently absorbed from the diet each day, yet plasma concentrations of these ions deviate minimally post-prandially. This implies the existence of a blood-borne mineral buffer system to sequester calcium phosphates and minimise the risk of deposition in the soft tissues. Calciprotein particles (CPP), endogenous mineral-protein colloids containing the plasma protein fetuin-A, may fulfill this function but definitive evidence linking dietary mineral loading with their formation is lacking. Here we demonstrate that CPP are formed as a normal physiological response to feeding in healthy adults and that this occurs despite minimal change in conventional serum mineral markers. Further, in individuals with Chronic Kidney Disease (CKD), in whom mineral handling is impaired, we show that both fasting and post-prandial levels of CPP precursors are markedly augmented and strongly inversely correlated with kidney function. This study highlights the important, but often neglected, contribution of colloidal biochemistry to mineral homeostasis and provides novel insight into the dysregulation of mineral metabolism in CKD.
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Fetuin-A is an inhibitor of calcium phosphate precipitation in the blood and has been shown not to be regulated in the post-prandial response of healthy volunteers.
“Fetuin-A is an inhibitor of calcium phosphate precipitation in the blood [54] and has been shown to be not regulated in the post-prandial response of healthy volunteers [53].”
From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [53]
The citation [53] attaches to the post-prandial claim. The Discussion (page unavailable) says fetuin-A appeared stable in healthy controls, but also reports increases at 30 and 60 minutes in an uncorrected analysis and cautions that the study may have been underpowered to detect an effect. The source therefore does not establish that fetuin-A is not regulated after a meal. (LLM, conf=0.87)
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Sorted by citations
Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels
Gerber, J. S., Arroyo, E. M. P., Pastor, J., Correia, M., Rudloff, S., Moe, O. W., Egli-Spichtig, D., Mohebbi, N., & Wagner, C. A. (2025) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-024-03046-4 · Cited by 15 · see citing works
- Authors
- Tiong, M. K., Cai, M. M. X., Toussaint, N. D., Tan, S.-J., Pasch, A., & Smith, E. R.
- Affiliations
- The Royal Melbourne Hospital (AU)
- Johannes Kepler University of Linz (AT)
- Corresponding author
- Tiong, Mark K.
- Smith, Edward R.
- ORCID
- Venue
- Scientific Reports
- Published
- 2022-05-05
- Volume
- 12
- Issue
- 1
- Pages
- 7358-7358
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC9072391
- OpenAlex
- W4229043273
- Cited by
- 38
- References
- 70
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 14 · 2023: 6 · 2022: 6
- FWCI
- 4.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- Royal Melbourne Hospital Research Funding Program Grant in Aid (Grant number 2018.036)
- Topics
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Alkaline Phosphatase Research Studies
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Keywords
- calciprotein particles, fetuin-A, dietary calcium, dietary phosphorus, chronic kidney disease, mineral homeostasis, renal function, calcium phosphate deposition
- MeSH terms
- Adult, Calcium, Calcium, Dietary, Female, Humans, Kidney, Kinetics, Male, Minerals, Phosphates, Biomarkers, Renal Insufficiency, Chronic
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